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 $302.00 Median $4,365.16 Typical High $10,471.29 | Facility | None | $302.00 | $4,365.16 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $416.87 | Professional | None | $288.40 | $346.74 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $562.34 Typical High $2,691.53 | Facility | None | $302.00 | $562.34 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $645.65 | Professional | None | $263.03 | $380.19 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $630.96 | Professional | None | $457.09 | $630.96 | $630.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $457.09 Median $776.25 Typical High $12,589.25 | Facility | None | $457.09 | $776.25 | $12,589.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $676.08 | Professional | None | $269.15 | $457.09 | $676.08 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $501.19 | Professional | None | $199.53 | $295.12 | $501.19 |
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 $144.54 Median $173.78 Typical High $208.93 | Professional | 52 · Reduced service | $144.54 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $69.18 Typical High $85.11 | Professional | 53 · Discontinued | $57.54 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $257.04 Typical High $316.23 | Professional | 54 · Surgery only | $218.78 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $51.29 Typical High $63.10 | Professional | 55 · Aftercare only | $43.65 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $34.67 Typical High $41.69 | Professional | 56 · Pre-op care only | $28.84 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $239.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $204.17 | $239.88 | $295.12 |
Where New Jersey sits
The same service costs 5.2 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· 41st of 51
$347
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.