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 $354.81 Median $3,467.37 Typical High $10,232.93 | Facility | None | $354.81 | $3,467.37 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $489.78 | Professional | None | $323.59 | $446.68 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,949.84 Typical High $3,311.31 | Facility | None | $691.83 | $1,949.84 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $691.83 | Professional | None | $245.47 | $389.05 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $630.96 Median $891.25 Typical High $912.01 | Professional | None | $630.96 | $891.25 | $912.01 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,890.45 Typical High $13,489.63 | Facility | None | $2,137.96 | $3,890.45 | $13,489.63 |
Horizon BCBS Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $851.14 | Professional | None | $331.13 | $588.84 | $851.14 |
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 $213.80 Median $338.84 Typical High $501.19 | Professional | None | $213.80 | $338.84 | $501.19 |
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 $162.18 Median $223.87 Typical High $245.47 | Professional | 52 · Reduced service | $162.18 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $89.13 Typical High $97.72 | Professional | 53 · Discontinued | $66.07 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $48.98 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $44.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $32.36 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $309.03 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $309.03 | $346.74 |
Where New Jersey sits
The same service costs 3.7 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
$389
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.