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 $891.25 Median $6,918.31 Typical High $11,748.98 | Facility | None | $891.25 | $6,918.31 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,445.44 | Professional | None | $660.69 | $776.25 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,089.30 Typical High $2,818.38 | Facility | None | $724.44 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $2,238.72 | Professional | None | $724.44 | $891.25 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,174.90 | Professional | None | $851.14 | $1,174.90 | $1,174.90 |
Horizon BCBS Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $2,187.76 | Professional | None | $794.33 | $933.25 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,995.26 | Professional | None | $549.54 | $794.33 | $1,995.26 |
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 $331.13 Median $331.13 Typical High $512.86 | Professional | 52 · Reduced service | $331.13 | $331.13 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $204.17 | Professional | 53 · Discontinued | $131.83 | $131.83 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $758.58 | Professional | 54 · Surgery only | $489.78 | $489.78 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $154.88 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $102.33 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $707.95 |
Where New Jersey sits
The same service costs 6.2 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· 42nd of 51
$933
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.