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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $194.98 | Professional | None | $85.11 | $144.54 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $239.88 Typical High $371.54 | Facility | None | $134.90 | $239.88 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $380.19 | Professional | None | $75.86 | $141.25 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $309.03 | Professional | None | $204.17 | $309.03 | $309.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $199.53 Median $363.08 Typical High $891.25 | Facility | None | $199.53 | $363.08 | $891.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $102.33 Median $213.80 Typical High $501.19 | Professional | None | $102.33 | $213.80 | $501.19 |
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 $81.28 Median $151.36 Typical High $346.74 | Professional | None | $81.28 | $151.36 | $346.74 |
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 $42.66 Median $72.44 Typical High $95.50 | Professional | 52 · Reduced service | $42.66 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $29.51 Typical High $38.90 | Professional | 53 · Discontinued | $16.98 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $109.65 Typical High $144.54 | Professional | 54 · Surgery only | $64.57 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $21.88 Typical High $28.84 | Professional | 55 · Aftercare only | $12.88 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $14.45 Typical High $19.05 | Professional | 56 · Pre-op care only | $8.51 | $14.45 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $102.33 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $60.26 | $102.33 | $134.90 |
Where New Jersey sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 33rd of 51
$182
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.