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 $263.03 Median $295.12 Typical High $354.81 | Professional | None | $263.03 | $295.12 | $354.81 |
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 $281.84 Median $331.13 Typical High $616.60 | Professional | None | $281.84 | $331.13 | $616.60 |
Emblem Health Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $562.34 | Professional | None | $416.87 | $562.34 | $562.34 |
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 $302.00 Median $354.81 Typical High $691.83 | Professional | None | $302.00 | $354.81 | $691.83 |
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 $223.87 Median $288.40 Typical High $436.52 | Professional | None | $223.87 | $288.40 | $436.52 |
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 $131.83 Median $147.91 Typical High $158.49 | Professional | 52 · Reduced service | $131.83 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $58.88 Typical High $63.10 | Professional | 53 · Discontinued | $52.48 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $218.78 Typical High $234.42 | Professional | 54 · Surgery only | $199.53 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $44.67 Typical High $47.86 | Professional | 55 · Aftercare only | $39.81 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $29.51 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.30 | $29.51 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $204.17 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $186.21 | $204.17 | $218.78 |
Where New Jersey sits
The same service costs 5.8 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· 38th of 51
$302
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.