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 $234.42 Median $4,365.16 Typical High $10,471.29 | Facility | None | $234.42 | $4,365.16 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $263.03 | Professional | None | $234.42 | $257.04 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $245.47 Typical High $380.19 | Facility | None | $141.25 | $245.47 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $501.19 | Professional | None | $229.09 | $263.03 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $446.68 | Professional | None | $331.13 | $446.68 | $446.68 |
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 $245.47 Median $295.12 Typical High $549.54 | Professional | None | $245.47 | $295.12 | $549.54 |
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 $181.97 Median $223.87 Typical High $363.08 | Professional | None | $181.97 | $223.87 | $363.08 |
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 $117.49 Median $123.03 Typical High $131.83 | Professional | 52 · Reduced service | $117.49 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $48.98 Typical High $53.70 | Professional | 53 · Discontinued | $46.77 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $199.53 | Professional | 54 · Surgery only | $177.83 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $39.81 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $26.30 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $169.82 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $165.96 | $169.82 | $186.21 |
Where New Jersey sits
The same service costs 5.1 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
$251
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.