How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $213.80 | Professional | None | $134.90 | $190.55 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $309.03 Typical High $1,659.59 | Facility | None | $173.78 | $309.03 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $371.54 | Professional | None | $102.33 | $190.55 | $371.54 |
Emblem Health Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $389.05 | Professional | None | $269.15 | $363.08 | $389.05 |
Horizon BCBS Setting Facility Modifier None Typical Low $257.04 Median $489.78 Typical High $1,513.56 | Facility | None | $257.04 | $489.78 | $1,513.56 |
Horizon BCBS Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $398.11 | Professional | None | $165.96 | $281.84 | $398.11 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,412.54 Typical High $3,801.89 | Facility | None | $316.23 | $1,412.54 | $3,801.89 |
United Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $323.59 | Professional | None | $77.62 | $138.04 | $323.59 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $93.33 Typical High $107.15 | Professional | 52 · Reduced service | $67.61 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $38.02 Typical High $42.66 | Professional | 53 · Discontinued | $26.92 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $141.25 Typical High $162.18 | Professional | 54 · Surgery only | $100.00 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $28.18 Typical High $32.36 | Professional | 55 · Aftercare only | $20.42 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.05 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.49 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $131.83 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $93.33 | $131.83 | $151.36 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Jersey· 43rd of 51
$209
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.