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 $186.21 Median $6,918.31 Typical High $12,882.50 | Facility | None | $186.21 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $229.09 | Professional | None | $117.49 | $186.21 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $389.05 | Facility | None | $66.07 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $147.91 Typical High $398.11 | Professional | None | $77.62 | $147.91 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $346.74 | Professional | None | $223.87 | $346.74 | $346.74 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $3,090.30 Typical High $4,265.80 | Facility | None | $2,041.74 | $3,090.30 | $4,265.80 |
Horizon BCBS Setting Professional Modifier None Typical Low $114.82 Median $234.42 Typical High $588.84 | Professional | None | $114.82 | $234.42 | $588.84 |
United Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,623.41 | Facility | None | $724.44 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $85.11 Median $158.49 Typical High $398.11 | Professional | None | $85.11 | $158.49 | $398.11 |
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 $58.88 Median $87.10 Typical High $114.82 | Professional | 52 · Reduced service | $58.88 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $34.67 Typical High $45.71 | Professional | 53 · Discontinued | $23.44 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $128.82 Typical High $169.82 | Professional | 54 · Surgery only | $89.13 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.92 Typical High $33.88 | Professional | 55 · Aftercare only | $17.78 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $18.20 Typical High $22.91 | Professional | 56 · Pre-op care only | $11.75 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $120.23 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $83.18 | $120.23 | $158.49 |
Where New Jersey sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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
$195
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.