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 $457.09 Median $489.78 Typical High $524.81 | Professional | None | $457.09 | $489.78 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $309.03 Typical High $1,659.59 | Facility | None | $162.18 | $309.03 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $1,023.29 | Professional | None | $478.63 | $549.54 | $1,023.29 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $933.25 | Professional | None | $724.44 | $933.25 | $933.25 |
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 $512.86 Median $588.84 Typical High $1,096.48 | Professional | None | $512.86 | $588.84 | $1,096.48 |
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 $371.54 Median $478.63 Typical High $741.31 | Professional | None | $371.54 | $478.63 | $741.31 |
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 $229.09 Median $245.47 Typical High $263.03 | Professional | 52 · Reduced service | $229.09 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $104.71 | Professional | 53 · Discontinued | $91.20 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $363.08 Typical High $398.11 | Professional | 54 · Surgery only | $346.74 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $74.13 Typical High $79.43 | Professional | 55 · Aftercare only | $69.18 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $52.48 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $338.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $323.59 | $338.84 | $371.54 |
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· 41st of 51
$513
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.