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 $707.95 Median $6,918.31 Typical High $12,882.50 | Facility | None | $707.95 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $870.96 | Professional | None | $575.44 | $707.95 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $275.42 Typical High $2,691.53 | Facility | None | $147.91 | $275.42 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $1,202.26 | Professional | None | $478.63 | $691.83 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | None | $851.14 | $1,148.15 | $1,148.15 |
Horizon BCBS Setting Facility Modifier None Typical Low $199.53 Median $363.08 Typical High $891.25 | Facility | None | $199.53 | $363.08 | $891.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $1,288.25 | Professional | None | $446.68 | $645.65 | $1,288.25 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,348.96 Typical High $3,890.45 | Facility | None | $309.03 | $1,348.96 | $3,890.45 |
United Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $912.01 | Professional | None | $346.74 | $549.54 | $912.01 |
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 $288.40 Median $331.13 Typical High $436.52 | Professional | 52 · Reduced service | $288.40 | $331.13 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $131.83 Typical High $173.78 | Professional | 53 · Discontinued | $114.82 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $501.19 Typical High $645.65 | Professional | 54 · Surgery only | $436.52 | $501.19 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $100.00 Typical High $131.83 | Professional | 55 · Aftercare only | $87.10 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $66.07 Typical High $87.10 | Professional | 56 · Pre-op care only | $57.54 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $467.74 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $407.38 | $467.74 | $602.56 |
Where New Jersey sits
The same service costs 3.6 times more in Alaska than in Maryland. 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
$631
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.