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 $4,365.16 Median $9,120.11 Typical High $14,125.38 | Facility | None | $4,365.16 | $9,120.11 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $323.59 | Professional | None | $190.55 | $281.84 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,818.38 Typical High $4,466.84 | Facility | None | $1,548.82 | $2,818.38 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $467.74 | Professional | None | $147.91 | $269.15 | $467.74 |
Emblem Health Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $616.60 | Professional | None | $436.52 | $602.56 | $616.60 |
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 $199.53 Median $389.05 Typical High $562.34 | Professional | None | $199.53 | $389.05 | $562.34 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $346.74 | Professional | None | $131.83 | $213.80 | $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 $95.50 Median $141.25 Typical High $162.18 | Professional | 52 · Reduced service | $95.50 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $56.23 Typical High $64.57 | Professional | 53 · Discontinued | $38.02 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $213.80 Typical High $245.47 | Professional | 54 · Surgery only | $144.54 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $42.66 Typical High $48.98 | Professional | 55 · Aftercare only | $28.84 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $28.18 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.05 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $199.53 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $134.90 | $199.53 | $229.09 |
Where New Jersey sits
The same service costs 3.7 times more in Wyoming than in Texas. 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· 47th of 51
$257
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.