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 $169.82 Median $4,466.84 Typical High $10,471.29 | Facility | None | $169.82 | $4,466.84 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $213.80 Typical High $239.88 | Professional | None | $151.36 | $213.80 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $323.59 Typical High $2,691.53 | Facility | None | $177.83 | $323.59 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $338.84 | Professional | None | $112.20 | $165.96 | $338.84 |
Emblem Health Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $389.05 | Professional | None | $281.84 | $389.05 | $389.05 |
Horizon BCBS Setting Facility Modifier None Typical Low $263.03 Median $501.19 Typical High $13,489.63 | Facility | None | $263.03 | $501.19 | $13,489.63 |
Horizon BCBS Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $389.05 | Professional | None | $154.88 | $269.15 | $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 $100.00 Median $154.88 Typical High $229.09 | Professional | None | $100.00 | $154.88 | $229.09 |
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 $75.86 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $75.86 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $42.66 Typical High $47.86 | Professional | 53 · Discontinued | $30.20 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $158.49 Typical High $177.83 | Professional | 54 · Surgery only | $112.20 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $21.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $147.91 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $104.71 | $147.91 | $165.96 |
Where New Jersey sits
The same service costs 3.8 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
$170
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.