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 $162.18 Median $3,388.44 Typical High $10,000.00 | Facility | None | $162.18 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $281.84 | Professional | None | $162.18 | $263.03 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,995.26 | Facility | None | $707.95 | $1,202.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $407.38 | Professional | None | $158.49 | $257.04 | $407.38 |
Emblem Health Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $446.68 | Professional | None | $323.59 | $446.68 | $446.68 |
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 $151.36 Median $309.03 Typical High $501.19 | Professional | None | $151.36 | $309.03 | $501.19 |
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 $117.49 Median $208.93 Typical High $316.23 | Professional | None | $117.49 | $208.93 | $316.23 |
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 $81.28 Median $112.20 Typical High $138.04 | Professional | 52 · Reduced service | $81.28 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $44.67 Typical High $54.95 | Professional | 53 · Discontinued | $32.36 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $120.23 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.88 Typical High $41.69 | Professional | 55 · Aftercare only | $23.99 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $22.39 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.22 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $112.20 | $158.49 | $190.55 |
Where New Jersey sits
The same service costs 4.5 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· 40th of 51
$234
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.