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 $75.86 Median $100.00 Typical High $151.36 | Professional | None | $75.86 | $100.00 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $190.55 Typical High $1,659.59 | Facility | None | $107.15 | $190.55 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $194.98 | Professional | None | $81.28 | $114.82 | $194.98 |
Emblem Health Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $204.17 | Professional | None | $147.91 | $204.17 | $204.17 |
Horizon BCBS Setting Facility Modifier None Typical Low $144.54 Median $269.15 Typical High $933.25 | Facility | None | $144.54 | $269.15 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $223.87 | Professional | None | $81.28 | $125.89 | $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 $60.26 Median $95.50 Typical High $144.54 | Professional | None | $60.26 | $95.50 | $144.54 |
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 $38.02 Median $45.71 Typical High $54.95 | Professional | 52 · Reduced service | $38.02 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $18.20 Typical High $21.88 | Professional | 53 · Discontinued | $15.14 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $69.18 Typical High $83.18 | Professional | 54 · Surgery only | $57.54 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.80 Typical High $16.60 | Professional | 55 · Aftercare only | $11.48 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.12 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.59 | $9.12 | $10.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $53.70 Median $64.57 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $53.70 | $64.57 | $77.62 |
Where New Jersey sits
The same service costs 3.7 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· 41st of 51
$105
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.