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 $154.88 Median $3,388.44 Typical High $10,000.00 | Facility | None | $154.88 | $3,388.44 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $229.09 | Professional | None | $151.36 | $169.82 | $229.09 |
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 $154.88 Median $186.21 Typical High $331.13 | Professional | None | $154.88 | $186.21 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $323.59 | Professional | None | $234.42 | $323.59 | $323.59 |
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 $147.91 Median $208.93 Typical High $371.54 | Professional | None | $147.91 | $208.93 | $371.54 |
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 $120.23 Median $154.88 Typical High $251.19 | Professional | None | $120.23 | $154.88 | $251.19 |
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 $75.86 Median $81.28 Typical High $93.33 | Professional | 52 · Reduced service | $75.86 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.11 Typical High $37.15 | Professional | 53 · Discontinued | $30.20 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $123.03 Typical High $138.04 | Professional | 54 · Surgery only | $112.20 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $24.55 Typical High $27.54 | Professional | 55 · Aftercare only | $22.39 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.60 Typical High $18.62 | Professional | 56 · Pre-op care only | $15.14 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $114.82 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $104.71 | $114.82 | $128.82 |
Where New Jersey sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 43rd of 51
$170
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.