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 $85.11 Median $144.54 Typical High $10,471.29 | Facility | None | $85.11 | $144.54 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $144.54 | Professional | None | $85.11 | $117.49 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $131.83 Typical High $1,659.59 | Facility | None | $74.13 | $131.83 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $199.53 | Professional | None | $81.28 | $107.15 | $199.53 |
Emblem Health Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $169.82 | Professional | None | $123.03 | $169.82 | $169.82 |
Horizon BCBS Setting Facility Modifier None Typical Low $104.71 Median $194.98 Typical High $933.25 | Facility | None | $104.71 | $194.98 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $223.87 | Professional | None | $83.18 | $117.49 | $223.87 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $138.04 | Professional | None | $58.88 | $81.28 | $138.04 |
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 $42.66 Median $48.98 Typical High $72.44 | Professional | 52 · Reduced service | $42.66 | $48.98 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.50 Typical High $28.84 | Professional | 53 · Discontinued | $16.98 | $19.50 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $72.44 Typical High $109.65 | Professional | 54 · Surgery only | $63.10 | $72.44 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.45 Typical High $21.88 | Professional | 55 · Aftercare only | $12.59 | $14.45 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.77 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.51 | $9.77 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $67.61 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $58.88 | $67.61 | $102.33 |
Where New Jersey sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 44th of 51
$97.72
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.