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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $724.44 | Professional | None | $501.19 | $562.34 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $3,467.37 Typical High $6,760.83 | Facility | None | $933.25 | $3,467.37 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $1,479.11 | Professional | None | $467.74 | $676.08 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $954.99 | Professional | None | $645.65 | $954.99 | $954.99 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,317.64 Typical High $22,387.21 | Facility | None | $4,677.35 | $8,317.64 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,778.28 | Professional | None | $602.56 | $724.44 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $1,380.38 | Professional | None | $446.68 | $588.84 | $1,380.38 |
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 $251.19 Median $251.19 Typical High $354.81 | Professional | 52 · Reduced service | $251.19 | $251.19 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $141.25 | Professional | 53 · Discontinued | $100.00 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $537.03 | Professional | 54 · Surgery only | $380.19 | $380.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $107.15 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $70.79 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $501.19 |
Where New Jersey sits
The same service costs 8.1 times more in Oklahoma 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· 41st of 51
$776
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.