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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $309.03 | Professional | None | $158.49 | $239.88 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $436.52 Typical High $1,659.59 | Facility | None | $245.47 | $436.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $562.34 | Professional | None | $120.23 | $208.93 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $416.87 | Professional | None | $275.42 | $416.87 | $416.87 |
Horizon BCBS Setting Facility Modifier None Typical Low $371.54 Median $691.83 Typical High $13,489.63 | Facility | None | $371.54 | $691.83 | $13,489.63 |
Horizon BCBS Setting Professional Modifier None Typical Low $162.18 Median $309.03 Typical High $741.31 | Professional | None | $162.18 | $309.03 | $741.31 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,754.40 | Facility | None | $707.95 | $1,995.26 | $5,754.40 |
United Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $512.86 | Professional | None | $114.82 | $199.53 | $512.86 |
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 $79.43 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $79.43 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $31.62 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $120.23 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $35.48 Typical High $41.69 | Professional | 55 · Aftercare only | $23.99 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.85 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $162.18 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $112.20 | $162.18 | $194.98 |
Where New Jersey sits
The same service costs 4.3 times more in Wisconsin than in Kentucky. 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· 39th of 51
$269
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.