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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $218.78 Typical High $239.88 | Professional | None | $213.80 | $218.78 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $2,187.76 | Facility | None | $691.83 | $1,380.38 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $478.63 | Professional | None | $234.42 | $275.42 | $478.63 |
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 $1,318.26 Median $2,511.89 Typical High $6,456.54 | Facility | None | $1,318.26 | $2,511.89 | $6,456.54 |
Horizon BCBS Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $537.03 | Professional | None | $251.19 | $275.42 | $537.03 |
United Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,623.41 | Facility | None | $724.44 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $338.84 | Professional | None | $190.55 | $229.09 | $338.84 |
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 $107.15 Median $109.65 Typical High $120.23 | Professional | 52 · Reduced service | $107.15 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $43.65 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $181.97 | Professional | 54 · Surgery only | $162.18 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.88 Typical High $23.99 | Professional | 56 · Pre-op care only | $21.38 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $169.82 |
Where New Jersey sits
The same service costs 5.4 times more in Alaska than in Utah. 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
$251
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.