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 $3,311.31 Typical High $10,000.00 | Facility | None | $151.36 | $3,311.31 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $346.74 Typical High $416.87 | Professional | None | $151.36 | $346.74 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,202.26 Typical High $1,995.26 | Facility | None | $616.60 | $1,202.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $346.74 Typical High $562.34 | Professional | None | $147.91 | $346.74 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $616.60 | Professional | None | $446.68 | $616.60 | $616.60 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,137.96 Typical High $6,760.83 | Facility | None | $1,174.90 | $2,137.96 | $6,760.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $141.25 Median $398.11 Typical High $691.83 | Professional | None | $141.25 | $398.11 | $691.83 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $114.82 Median $288.40 Typical High $436.52 | Professional | None | $114.82 | $288.40 | $436.52 |
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 $75.86 Median $158.49 Typical High $204.17 | Professional | 52 · Reduced service | $75.86 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $63.10 Typical High $83.18 | Professional | 53 · Discontinued | $30.90 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $234.42 Typical High $309.03 | Professional | 54 · Surgery only | $114.82 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $46.77 Typical High $61.66 | Professional | 55 · Aftercare only | $22.91 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $31.62 Typical High $41.69 | Professional | 56 · Pre-op care only | $15.14 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $218.78 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $107.15 | $218.78 | $288.40 |
Where New Jersey sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 34th of 51
$316
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.