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 $2,754.23 Median $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $5,370.32 | Professional | None | $107.15 | $117.49 | $5,370.32 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $5,248.07 Typical High $7,244.36 | Facility | None | $3,467.37 | $5,248.07 | $7,244.36 |
Horizon BCBS Setting Professional Modifier None Typical Low $134.90 Median $138.04 Typical High $213.80 | Professional | None | $134.90 | $138.04 | $213.80 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $5,128.61 Typical High $8,511.38 | Facility | None | $1,905.46 | $5,128.61 | $8,511.38 |
United Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $257.04 | Professional | None | $112.20 | $141.25 | $257.04 |
5 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 $53.70 Median $58.88 Typical High $60.26 | Professional | 52 · Reduced service | $53.70 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $23.44 Typical High $23.99 | Professional | 53 · Discontinued | $21.38 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | 54 · Surgery only | $79.43 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $15.85 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.75 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.72 | $11.75 | $12.02 |
Where New Jersey sits
The same service costs 37.2 times more in Oklahoma than in New York. 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· 8th of 51
$1,905
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.