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 $851.14 Median $6,309.57 Typical High $10,471.29 | Facility | None | $851.14 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,513.56 | Professional | None | $851.14 | $851.14 | $1,513.56 |
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 $707.95 Median $870.96 Typical High $2,290.87 | Professional | None | $707.95 | $870.96 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,174.90 | Professional | None | $794.33 | $1,174.90 | $1,174.90 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $2,630.27 | $5,011.87 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $2,290.87 | Professional | None | $794.33 | $933.25 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,949.84 | Professional | None | $501.19 | $724.44 | $1,949.84 |
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 $426.58 Median $426.58 Typical High $512.86 | Professional | 52 · Reduced service | $426.58 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $204.17 | Professional | 53 · Discontinued | $169.82 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | 54 · Surgery only | $630.96 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $707.95 |
Where New Jersey sits
The same service costs 6.6 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· 38th of 51
$1,023
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.