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 $37.15 Median $6,918.31 Typical High $12,882.50 | Facility | None | $37.15 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $37.15 Typical High $46.77 | Professional | None | $35.48 | $37.15 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $389.05 | Facility | None | $66.07 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $46.77 Typical High $83.18 | Professional | None | $28.18 | $46.77 | $83.18 |
Emblem Health Setting Professional Modifier None Typical Low $6.17 Median $48.98 Typical High $79.43 | Professional | None | $6.17 | $48.98 | $79.43 |
Horizon BCBS Setting Facility Modifier None Typical Low $131.83 Median $199.53 Typical High $275.42 | Facility | None | $131.83 | $199.53 | $275.42 |
Horizon BCBS Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $93.33 | Professional | None | $47.86 | $60.26 | $93.33 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $3,801.89 | Facility | None | $309.03 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $22.39 Median $33.11 Typical High $77.62 | Professional | None | $22.39 | $33.11 | $77.62 |
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 $17.78 Median $18.62 Typical High $22.91 | Professional | 52 · Reduced service | $17.78 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.41 Typical High $9.12 | Professional | 53 · Discontinued | $7.08 | $7.41 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $27.54 Typical High $33.88 | Professional | 54 · Surgery only | $26.92 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.50 Typical High $6.76 | Professional | 55 · Aftercare only | $5.37 | $5.50 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.72 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.55 | $3.72 | $4.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $25.12 Median $25.70 Typical High $31.62 | Professional | 78 · Unplanned return to OR | $25.12 | $25.70 | $31.62 |
Where New Jersey sits
The same service costs 4.6 times more in Alaska than in New York. 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· 49th of 51
$46.77
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.