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 $87.10 Median $104.71 Typical High $120.23 | Professional | None | $87.10 | $104.71 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $165.96 Typical High $354.81 | Facility | None | $87.10 | $165.96 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $223.87 | Professional | None | $87.10 | $123.03 | $223.87 |
Emblem Health Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $208.93 | Professional | None | $154.88 | $208.93 | $208.93 |
Horizon BCBS Setting Facility Modifier None Typical Low $741.31 Median $1,621.81 Typical High $6,309.57 | Facility | None | $741.31 | $1,621.81 | $6,309.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $229.09 | Professional | None | $85.11 | $131.83 | $229.09 |
United Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,623.41 | Facility | None | $724.44 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $169.82 | Professional | None | $69.18 | $100.00 | $169.82 |
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 $43.65 Median $51.29 Typical High $60.26 | Professional | 52 · Reduced service | $43.65 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $20.42 Typical High $23.99 | Professional | 53 · Discontinued | $17.38 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $77.62 Typical High $89.13 | Professional | 54 · Surgery only | $64.57 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.49 Typical High $18.20 | Professional | 55 · Aftercare only | $12.88 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.23 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.71 | $10.23 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $72.44 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $60.26 | $72.44 | $83.18 |
Where New Jersey sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 47th of 51
$107
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.