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 $199.53 Median $275.42 Typical High $316.23 | Professional | None | $199.53 | $275.42 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $549.54 Typical High $2,691.53 | Facility | None | $295.12 | $549.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $467.74 | Professional | None | $151.36 | $251.19 | $467.74 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $616.60 | Professional | None | $457.09 | $616.60 | $616.60 |
Horizon BCBS Setting Facility Modifier None Typical Low $407.38 Median $741.31 Typical High $5,888.44 | Facility | None | $407.38 | $741.31 | $5,888.44 |
Horizon BCBS Setting Professional Modifier None Typical Low $213.80 Median $407.38 Typical High $537.03 | Professional | None | $213.80 | $407.38 | $537.03 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $346.74 | Professional | None | $134.90 | $223.87 | $346.74 |
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 $100.00 Median $138.04 Typical High $158.49 | Professional | 52 · Reduced service | $100.00 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $54.95 Typical High $63.10 | Professional | 53 · Discontinued | $39.81 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $208.93 Typical High $234.42 | Professional | 54 · Surgery only | $147.91 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $41.69 Typical High $46.77 | Professional | 55 · Aftercare only | $29.51 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $27.54 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.95 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $194.98 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $138.04 | $194.98 | $218.78 |
Where New Jersey sits
The same service costs 3.6 times more in Alaska than in New Jersey. 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· 51st 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.