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 $141.25 Typical High $204.17 | Professional | None | $123.03 | $141.25 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $190.55 Typical High $2,691.53 | Facility | None | $102.33 | $190.55 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $446.68 | Professional | None | $147.91 | $190.55 | $446.68 |
Emblem Health Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $309.03 | Professional | None | $208.93 | $309.03 | $309.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $151.36 Median $281.84 Typical High $7,943.28 | Facility | None | $151.36 | $281.84 | $7,943.28 |
Horizon BCBS Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $549.54 | Professional | None | $158.49 | $213.80 | $549.54 |
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 $123.03 Median $169.82 Typical High $407.38 | Professional | None | $123.03 | $169.82 | $407.38 |
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 $70.79 Typical High $102.33 | Professional | 52 · Reduced service | $61.66 | $70.79 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.18 Typical High $40.74 | Professional | 53 · Discontinued | $25.12 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $107.15 Typical High $154.88 | Professional | 54 · Surgery only | $93.33 | $107.15 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.38 Typical High $30.90 | Professional | 55 · Aftercare only | $18.62 | $21.38 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.13 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.30 | $14.13 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $100.00 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $87.10 | $100.00 | $144.54 |
Where New Jersey sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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· 43rd of 51
$204
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.