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 $123.03 Median $6,918.31 Typical High $12,882.50 | Facility | None | $123.03 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $194.98 | Professional | None | $95.50 | $123.03 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $275.42 Typical High $389.05 | Facility | None | $66.07 | $275.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $316.23 | Professional | None | $95.50 | $141.25 | $316.23 |
Emblem Health Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $239.88 | Professional | None | $158.49 | $239.88 | $239.88 |
Horizon BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,513.56 Typical High $1,905.46 | Facility | None | $912.01 | $1,513.56 | $1,905.46 |
Horizon BCBS Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $371.54 | Professional | None | $102.33 | $154.88 | $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 $72.44 Median $112.20 Typical High $269.15 | Professional | None | $72.44 | $112.20 | $269.15 |
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 $47.86 Median $61.66 Typical High $70.79 | Professional | 52 · Reduced service | $47.86 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $24.55 Typical High $28.18 | Professional | 53 · Discontinued | $19.05 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $91.20 Typical High $107.15 | Professional | 54 · Surgery only | $72.44 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $18.20 Typical High $21.38 | Professional | 55 · Aftercare only | $14.45 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.30 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.55 | $12.30 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $85.11 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $67.61 | $85.11 | $100.00 |
Where New Jersey sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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
$141
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.