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 $263.03 Median $4,365.16 Typical High $10,471.29 | Facility | None | $263.03 | $4,365.16 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $380.19 | Professional | None | $229.09 | $257.04 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $245.47 Typical High $371.54 | Facility | None | $141.25 | $245.47 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $549.54 | Professional | None | $257.04 | $309.03 | $549.54 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $549.54 | Professional | None | $398.11 | $549.54 | $549.54 |
Horizon BCBS Setting Facility Modifier None Typical Low $199.53 Median $363.08 Typical High $933.25 | Facility | None | $199.53 | $363.08 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $275.42 Median $331.13 Typical High $616.60 | Professional | None | $275.42 | $331.13 | $616.60 |
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 $208.93 Median $275.42 Typical High $407.38 | Professional | None | $208.93 | $275.42 | $407.38 |
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 $114.82 Median $128.82 Typical High $144.54 | Professional | 52 · Reduced service | $114.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $51.29 Typical High $57.54 | Professional | 53 · Discontinued | $45.71 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $194.98 Typical High $218.78 | Professional | 54 · Surgery only | $173.78 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.90 Typical High $43.65 | Professional | 55 · Aftercare only | $34.67 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $28.84 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $181.97 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $162.18 | $181.97 | $204.17 |
Where New Jersey sits
The same service costs 5.4 times more in Alaska than in Texas. 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
$282
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.