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 $295.12 Median $4,570.88 Typical High $10,000.00 | Facility | None | $295.12 | $4,570.88 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $457.09 | Professional | None | $295.12 | $426.58 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $588.84 Typical High $2,691.53 | Facility | None | $316.23 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $707.95 | Professional | None | $288.40 | $416.87 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $707.95 | Professional | None | $512.86 | $707.95 | $707.95 |
Horizon BCBS Setting Facility Modifier None Typical Low $467.74 Median $891.25 Typical High $6,456.54 | Facility | None | $467.74 | $891.25 | $6,456.54 |
Horizon BCBS Setting Professional Modifier None Typical Low $275.42 Median $512.86 Typical High $831.76 | Professional | None | $275.42 | $512.86 | $831.76 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $524.81 | Professional | None | $223.87 | $331.13 | $524.81 |
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 $147.91 Median $186.21 Typical High $229.09 | Professional | 52 · Reduced service | $147.91 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $74.13 Typical High $91.20 | Professional | 53 · Discontinued | $58.88 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $281.84 Typical High $346.74 | Professional | 54 · Surgery only | $218.78 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $56.23 Typical High $69.18 | Professional | 55 · Aftercare only | $43.65 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $37.15 Typical High $45.71 | Professional | 56 · Pre-op care only | $29.51 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $263.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $204.17 | $263.03 | $323.59 |
Where New Jersey sits
The same service costs 4.7 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· 42nd of 51
$380
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.