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 $229.09 Median $4,786.30 Typical High $10,232.93 | Facility | None | $229.09 | $4,786.30 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $323.59 | Professional | None | $199.53 | $281.84 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $616.60 Typical High $2,187.76 | Facility | None | $354.81 | $616.60 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $263.03 Typical High $660.69 | Professional | None | $134.90 | $263.03 | $660.69 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $501.19 | Professional | None | $331.13 | $501.19 | $501.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $436.52 Median $794.33 Typical High $2,187.76 | Facility | None | $436.52 | $794.33 | $2,187.76 |
Horizon BCBS Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $851.14 | Professional | None | $199.53 | $354.81 | $851.14 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $3,890.45 | Facility | None | $309.03 | $1,380.38 | $3,890.45 |
United Setting Professional Modifier None Typical Low $141.25 Median $239.88 Typical High $602.56 | Professional | None | $141.25 | $239.88 | $602.56 |
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 $100.00 Median $134.90 Typical High $162.18 | Professional | 52 · Reduced service | $100.00 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $54.95 Typical High $64.57 | Professional | 53 · Discontinued | $39.81 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $204.17 Typical High $245.47 | Professional | 54 · Surgery only | $151.36 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $30.20 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $27.54 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.95 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $190.55 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $141.25 | $190.55 | $229.09 |
Where New Jersey sits
The same service costs 3.7 times more in Wisconsin 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· 37th of 51
$309
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.