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 $151.36 Median $4,466.84 Typical High $9,772.37 | Facility | None | $151.36 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $275.42 | Professional | None | $144.54 | $194.98 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $338.84 Typical High $1,659.59 | Facility | None | $190.55 | $338.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $354.81 | Professional | None | $151.36 | $213.80 | $354.81 |
Emblem Health Setting Professional Modifier None Typical Low $20.42 Median $177.83 Typical High $380.19 | Professional | None | $20.42 | $177.83 | $380.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $257.04 Median $478.63 Typical High $6,760.83 | Facility | None | $257.04 | $478.63 | $6,760.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $389.05 | Professional | None | $144.54 | $245.47 | $389.05 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $269.15 | Professional | None | $112.20 | $177.83 | $269.15 |
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 $72.44 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $72.44 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $37.15 Typical High $42.66 | Professional | 53 · Discontinued | $28.84 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $109.65 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $27.54 Typical High $31.62 | Professional | 55 · Aftercare only | $21.88 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $14.45 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $128.82 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $102.33 | $128.82 | $147.91 |
Where New Jersey sits
The same service costs 3.5 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· 43rd of 51
$195
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.