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 $331.13 Median $6,918.31 Typical High $12,882.50 | Facility | None | $331.13 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $380.19 | Professional | None | $239.88 | $331.13 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $831.76 Typical High $2,691.53 | Facility | None | $457.09 | $831.76 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $602.56 | Professional | None | $208.93 | $338.84 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $851.14 | Professional | None | $616.60 | $851.14 | $851.14 |
Horizon BCBS Setting Facility Modifier None Typical Low $616.60 Median $1,174.90 Typical High $12,589.25 | Facility | None | $616.60 | $1,174.90 | $12,589.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $691.83 | Professional | None | $288.40 | $524.81 | $691.83 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $457.09 | Professional | None | $190.55 | $302.00 | $457.09 |
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 $120.23 Median $165.96 Typical High $190.55 | Professional | 52 · Reduced service | $120.23 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $47.86 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $245.47 Typical High $281.84 | Professional | 54 · Surgery only | $177.83 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $48.98 Typical High $56.23 | Professional | 55 · Aftercare only | $35.48 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $33.11 Typical High $38.02 | Professional | 56 · Pre-op care only | $23.99 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $229.09 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $165.96 | $229.09 | $263.03 |
Where New Jersey sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 50th of 51
$331
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.