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 $117.49 Median $208.93 Typical High $239.88 | Professional | None | $117.49 | $208.93 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $295.12 Typical High $1,659.59 | Facility | None | $154.88 | $295.12 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $154.88 Typical High $309.03 | Professional | None | $75.86 | $154.88 | $309.03 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $380.19 | Professional | None | $275.42 | $380.19 | $380.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $199.53 Median $363.08 Typical High $891.25 | Facility | None | $199.53 | $363.08 | $891.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $112.20 Median $245.47 Typical High $371.54 | Professional | None | $112.20 | $245.47 | $371.54 |
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 $75.86 Median $141.25 Typical High $218.78 | Professional | None | $75.86 | $141.25 | $218.78 |
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 $95.50 Typical High $120.23 | Professional | 52 · Reduced service | $58.88 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $38.02 Typical High $47.86 | Professional | 53 · Discontinued | $23.44 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $144.54 Typical High $177.83 | Professional | 54 · Surgery only | $87.10 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $28.84 Typical High $35.48 | Professional | 55 · Aftercare only | $17.38 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $19.05 Typical High $23.99 | Professional | 56 · Pre-op care only | $11.75 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $134.90 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $81.28 | $134.90 | $165.96 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska 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· 44th of 51
$155
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.