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 $5,888.44 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $426.58 | Professional | None | $208.93 | $295.12 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $426.58 Typical High $2,187.76 | Facility | None | $229.09 | $426.58 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $263.03 Typical High $676.08 | Professional | None | $134.90 | $263.03 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $478.63 | Professional | None | $316.23 | $478.63 | $478.63 |
Horizon BCBS Setting Facility Modifier None Typical Low $338.84 Median $602.56 Typical High $2,041.74 | Facility | None | $338.84 | $602.56 | $2,041.74 |
Horizon BCBS Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $1,000.00 | Professional | None | $199.53 | $346.74 | $1,000.00 |
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 $138.04 Median $229.09 Typical High $660.69 | Professional | None | $138.04 | $229.09 | $660.69 |
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 $104.71 Median $138.04 Typical High $199.53 | Professional | 52 · Reduced service | $104.71 | $138.04 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $54.95 Typical High $79.43 | Professional | 53 · Discontinued | $41.69 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $204.17 Typical High $302.00 | Professional | 54 · Surgery only | $154.88 | $204.17 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $40.74 Typical High $60.26 | Professional | 55 · Aftercare only | $30.90 | $40.74 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $27.54 Typical High $39.81 | Professional | 56 · Pre-op care only | $20.89 | $27.54 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $190.55 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $144.54 | $190.55 | $281.84 |
Where New Jersey sits
The same service costs 3.7 times more in Wisconsin 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· 35th 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.