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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $257.04 | Professional | None | $123.03 | $204.17 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $426.58 Typical High $1,659.59 | Facility | None | $239.88 | $426.58 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $338.84 | Professional | None | $107.15 | $177.83 | $338.84 |
Emblem Health Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $446.68 | Professional | None | $316.23 | $446.68 | $446.68 |
Horizon BCBS Setting Facility Modifier None Typical Low $309.03 Median $549.54 Typical High $1,513.56 | Facility | None | $309.03 | $549.54 | $1,513.56 |
Horizon BCBS Setting Professional Modifier None Typical Low $131.83 Median $257.04 Typical High $371.54 | Professional | None | $131.83 | $257.04 | $371.54 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,412.54 Typical High $3,801.89 | Facility | None | $316.23 | $1,412.54 | $3,801.89 |
United Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $239.88 | Professional | None | $85.11 | $154.88 | $239.88 |
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 $61.66 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $61.66 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $24.55 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $91.20 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $30.20 Typical High $36.31 | Professional | 55 · Aftercare only | $18.20 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.30 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $85.11 | $141.25 | $169.82 |
Where New Jersey sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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
$178
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.