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 $218.78 Median $6,760.83 Typical High $11,748.98 | Facility | None | $218.78 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $288.40 | Professional | None | $144.54 | $218.78 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $239.88 Typical High $371.54 | Facility | None | $134.90 | $239.88 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $199.53 Typical High $501.19 | Professional | None | $102.33 | $199.53 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $380.19 | Professional | None | $251.19 | $380.19 | $380.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $204.17 Median $363.08 Typical High $891.25 | Facility | None | $204.17 | $363.08 | $891.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $162.18 Median $331.13 Typical High $724.44 | Professional | None | $162.18 | $331.13 | $724.44 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $104.71 Median $181.97 Typical High $524.81 | Professional | None | $104.71 | $181.97 | $524.81 |
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 $72.44 Median $104.71 Typical High $138.04 | Professional | 52 · Reduced service | $72.44 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $41.69 Typical High $54.95 | Professional | 53 · Discontinued | $28.84 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $158.49 Typical High $208.93 | Professional | 54 · Surgery only | $109.65 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $31.62 Typical High $41.69 | Professional | 55 · Aftercare only | $21.88 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.89 Typical High $27.54 | Professional | 56 · Pre-op care only | $14.45 | $20.89 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $147.91 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $102.33 | $147.91 | $194.98 |
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· 31st of 51
$251
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.