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 $4,466.84 Median $7,244.36 Typical High $11,748.98 | Facility | None | $4,466.84 | $7,244.36 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $912.01 | Professional | None | $645.65 | $645.65 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $6,760.83 | Facility | None | $1,318.26 | $3,890.45 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,905.46 | Professional | None | $588.84 | $812.83 | $1,905.46 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,202.26 | Professional | None | $851.14 | $1,202.26 | $1,202.26 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,128.31 Typical High $23,988.33 | Facility | None | $4,677.35 | $8,128.31 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $2,290.87 | Professional | None | $758.58 | $912.01 | $2,290.87 |
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 $575.44 Median $741.31 Typical High $1,778.28 | Professional | None | $575.44 | $741.31 | $1,778.28 |
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 $323.59 Median $323.59 Typical High $446.68 | Professional | 52 · Reduced service | $323.59 | $323.59 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $181.97 | Professional | 53 · Discontinued | $128.82 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $676.08 | Professional | 54 · Surgery only | $478.63 | $478.63 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $134.90 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $91.20 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $630.96 |
Where New Jersey sits
The same service costs 7.4 times more in Oklahoma than in Texas. 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· 40th of 51
$977
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.