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 $151.36 Median $3,548.13 Typical High $10,232.93 | Facility | None | $151.36 | $3,548.13 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $239.88 | Professional | None | $141.25 | $213.80 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $354.81 Typical High $1,659.59 | Facility | None | $199.53 | $354.81 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $331.13 | Professional | None | $97.72 | $165.96 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $380.19 | Professional | None | $251.19 | $380.19 | $380.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $288.40 Median $549.54 Typical High $13,489.63 | Facility | None | $288.40 | $549.54 | $13,489.63 |
Horizon BCBS Setting Professional Modifier None Typical Low $138.04 Median $275.42 Typical High $389.05 | Professional | None | $138.04 | $275.42 | $389.05 |
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 $87.10 Median $147.91 Typical High $234.42 | Professional | None | $87.10 | $147.91 | $234.42 |
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 $70.79 Median $102.33 Typical High $120.23 | Professional | 52 · Reduced service | $70.79 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $28.18 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $154.88 Typical High $181.97 | Professional | 54 · Surgery only | $104.71 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $30.90 Typical High $36.31 | Professional | 55 · Aftercare only | $20.89 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $14.13 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $144.54 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $97.72 | $144.54 | $169.82 |
Where New Jersey sits
The same service costs 3.5 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
$166
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.