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 $724.44 Median $6,309.57 Typical High $10,471.29 | Facility | None | $724.44 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $831.76 | Professional | None | $724.44 | $724.44 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,311.31 Typical High $6,025.60 | Facility | None | $1,174.90 | $3,311.31 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,905.46 | Professional | None | $616.60 | $741.31 | $1,905.46 |
Emblem Health Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,023.29 | Professional | None | $691.83 | $1,023.29 | $1,023.29 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $7,585.78 Typical High $19,952.62 | Facility | None | $4,168.69 | $7,585.78 | $19,952.62 |
Horizon BCBS Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,995.26 | Professional | None | $691.83 | $812.83 | $1,995.26 |
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 $436.52 Median $630.96 Typical High $1,698.24 | Professional | None | $436.52 | $630.96 | $1,698.24 |
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 $363.08 Median $363.08 Typical High $416.87 | Professional | 52 · Reduced service | $363.08 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $169.82 | Professional | 53 · Discontinued | $144.54 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | 54 · Surgery only | $549.54 | $549.54 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $588.84 |
Where New Jersey sits
The same service costs 8.7 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
$832
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.