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 $102.33 Median $154.88 Typical High $177.83 | Professional | None | $102.33 | $154.88 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $302.00 Typical High $2,187.76 | Facility | None | $162.18 | $302.00 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $245.47 | Professional | None | $75.86 | $134.90 | $245.47 |
Emblem Health Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $309.03 | Professional | None | $223.87 | $309.03 | $309.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $245.47 Median $436.52 Typical High $12,589.25 | Facility | None | $245.47 | $436.52 | $12,589.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $102.33 Median $208.93 Typical High $288.40 | Professional | None | $102.33 | $208.93 | $288.40 |
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 $67.61 Median $114.82 Typical High $177.83 | Professional | None | $67.61 | $114.82 | $177.83 |
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 $51.29 Median $75.86 Typical High $89.13 | Professional | 52 · Reduced service | $51.29 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $30.90 Typical High $35.48 | Professional | 53 · Discontinued | $20.42 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $114.82 Typical High $131.83 | Professional | 54 · Surgery only | $75.86 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $22.91 Typical High $26.30 | Professional | 55 · Aftercare only | $15.14 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.23 | $15.49 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $107.15 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $70.79 | $107.15 | $123.03 |
Where New Jersey sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 49th of 51
$135
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.