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 $323.59 Median $4,466.84 Typical High $9,772.37 | Facility | None | $323.59 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $575.44 | Professional | None | $323.59 | $467.74 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,348.96 Typical High $2,187.76 | Facility | None | $676.08 | $1,348.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $758.58 | Professional | None | $316.23 | $446.68 | $758.58 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $741.31 | Professional | None | $549.54 | $741.31 | $741.31 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $6,760.83 | Facility | None | $1,174.90 | $1,995.26 | $6,760.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $302.00 Median $549.54 Typical High $891.25 | Professional | None | $302.00 | $549.54 | $891.25 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $562.34 | Professional | None | $239.88 | $354.81 | $562.34 |
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 $162.18 Median $199.53 Typical High $245.47 | Professional | 52 · Reduced service | $162.18 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $81.28 Typical High $100.00 | Professional | 53 · Discontinued | $64.57 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $302.00 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $74.13 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $40.74 Typical High $50.12 | Professional | 56 · Pre-op care only | $32.36 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $281.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $281.84 | $346.74 |
Where New Jersey sits
The same service costs 4.9 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· 39th of 51
$427
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.