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 $4,466.84 Median $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $707.95 | Professional | None | $467.74 | $467.74 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $5,128.61 | Facility | None | $1,905.46 | $3,019.95 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $1,548.82 | Professional | None | $512.86 | $660.69 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $831.76 | Professional | None | $602.56 | $831.76 | $831.76 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $7,413.10 Typical High $20,417.38 | Facility | None | $3,890.45 | $7,413.10 | $20,417.38 |
Horizon BCBS Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $1,548.82 | Professional | None | $562.34 | $660.69 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,073.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $1,412.54 | Professional | None | $398.11 | $562.34 | $1,412.54 |
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 $234.42 Median $234.42 Typical High $354.81 | Professional | 52 · Reduced service | $234.42 | $234.42 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $144.54 | Professional | 53 · Discontinued | $93.33 | $93.33 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $537.03 | Professional | 54 · Surgery only | $354.81 | $354.81 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $107.15 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $70.79 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $501.19 |
Where New Jersey sits
The same service costs 9.8 times more in Oklahoma than in Utah. 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· 40th of 51
$759
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.