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 $281.84 Median $309.03 Typical High $398.11 | Professional | None | $281.84 | $309.03 | $398.11 |
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 $295.12 Median $346.74 Typical High $645.65 | Professional | None | $295.12 | $346.74 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $602.56 | Professional | None | $446.68 | $602.56 | $602.56 |
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 $323.59 Median $380.19 Typical High $691.83 | Professional | None | $323.59 | $380.19 | $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 $239.88 Median $309.03 Typical High $457.09 | Professional | None | $239.88 | $309.03 | $457.09 |
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 $141.25 Median $154.88 Typical High $165.96 | Professional | 52 · Reduced service | $141.25 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $67.61 | Professional | 53 · Discontinued | $56.23 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $208.93 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $50.12 | Professional | 55 · Aftercare only | $41.69 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $33.88 | Professional | 56 · Pre-op care only | $28.18 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $218.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $194.98 | $218.78 | $234.42 |
Where New Jersey sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 40th of 51
$324
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.