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 $165.96 Median $4,365.16 Typical High $10,471.29 | Facility | None | $165.96 | $4,365.16 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $257.04 Typical High $269.15 | Professional | None | $162.18 | $257.04 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $398.11 Typical High $1,659.59 | Facility | None | $223.87 | $398.11 | $1,659.59 |
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 $316.23 Median $436.52 Typical High $436.52 | Professional | None | $316.23 | $436.52 | $436.52 |
Horizon BCBS Setting Facility Modifier None Typical Low $309.03 Median $575.44 Typical High $6,760.83 | Facility | None | $309.03 | $575.44 | $6,760.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $489.78 | Professional | None | $165.96 | $302.00 | $489.78 |
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 $114.82 Median $204.17 Typical High $309.03 | Professional | None | $114.82 | $204.17 | $309.03 |
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 $79.43 Median $109.65 Typical High $134.90 | Professional | 52 · Reduced service | $79.43 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $43.65 Typical High $53.70 | Professional | 53 · Discontinued | $32.36 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $165.96 Typical High $204.17 | Professional | 54 · Surgery only | $120.23 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.11 Typical High $40.74 | Professional | 55 · Aftercare only | $23.99 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.22 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $154.88 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $112.20 | $154.88 | $190.55 |
Where New Jersey sits
The same service costs 4.4 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· 39th of 51
$224
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.