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 $758.58 Median $6,309.57 Typical High $10,471.29 | Facility | None | $758.58 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,380.38 | Professional | None | $758.58 | $758.58 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,570.40 Typical High $3,981.07 | Facility | None | $1,174.90 | $2,570.40 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,995.26 | Professional | None | $645.65 | $794.33 | $1,995.26 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,071.52 | Professional | None | $724.44 | $1,071.52 | $1,071.52 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $5,011.87 Typical High $14,454.40 | Facility | None | $2,630.27 | $5,011.87 | $14,454.40 |
Horizon BCBS Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $2,137.96 | Professional | None | $724.44 | $851.14 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,778.28 | Professional | None | $457.09 | $660.69 | $1,778.28 |
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 $380.19 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $154.88 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $575.44 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $616.60 |
Where New Jersey sits
The same service costs 7.9 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· 40th of 51
$891
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.