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 $234.42 Median $4,365.16 Typical High $10,471.29 | Facility | None | $234.42 | $4,365.16 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $363.08 | Professional | None | $204.17 | $295.12 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $588.84 Typical High $1,659.59 | Facility | None | $331.13 | $588.84 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $275.42 Typical High $676.08 | Professional | None | $144.54 | $275.42 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $512.86 | Professional | None | $338.84 | $512.86 | $512.86 |
Horizon BCBS Setting Facility Modifier None Typical Low $416.87 Median $776.25 Typical High $2,041.74 | Facility | None | $416.87 | $776.25 | $2,041.74 |
Horizon BCBS Setting Professional Modifier None Typical Low $223.87 Median $416.87 Typical High $912.01 | Professional | None | $223.87 | $416.87 | $912.01 |
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 $144.54 Median $245.47 Typical High $676.08 | Professional | None | $144.54 | $245.47 | $676.08 |
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 $102.33 Median $141.25 Typical High $173.78 | Professional | 52 · Reduced service | $102.33 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $56.23 Typical High $70.79 | Professional | 53 · Discontinued | $40.74 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $208.93 Typical High $263.03 | Professional | 54 · Surgery only | $154.88 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $41.69 Typical High $52.48 | Professional | 55 · Aftercare only | $30.90 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $28.18 Typical High $35.48 | Professional | 56 · Pre-op care only | $20.42 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $194.98 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $144.54 | $194.98 | $245.47 |
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
$339
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.