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 $165.96 Median $4,466.84 Typical High $9,772.37 | Facility | None | $165.96 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $371.54 | Professional | None | $147.91 | $204.17 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $3,801.89 | Facility | None | $933.25 | $2,290.87 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $489.78 | Professional | None | $162.18 | $208.93 | $489.78 |
Emblem Health Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $354.81 | Professional | None | $234.42 | $354.81 | $354.81 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $5,011.87 Typical High $13,182.57 | Facility | None | $2,818.38 | $5,011.87 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $630.96 | Professional | None | $177.83 | $239.88 | $630.96 |
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 $138.04 Median $194.98 Typical High $457.09 | Professional | None | $138.04 | $194.98 | $457.09 |
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 $72.44 Median $83.18 Typical High $114.82 | Professional | 52 · Reduced service | $72.44 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $33.11 Typical High $45.71 | Professional | 53 · Discontinued | $29.51 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $123.03 Typical High $173.78 | Professional | 54 · Surgery only | $109.65 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $24.55 Typical High $34.67 | Professional | 55 · Aftercare only | $21.88 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.60 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.79 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $114.82 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $102.33 | $114.82 | $162.18 |
Where New Jersey sits
The same service costs 5.9 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· 43rd of 51
$240
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.