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 $4,365.16 Median $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | None | $741.31 | $741.31 | $891.25 |
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 $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 $2,818.38 Median $4,897.79 Typical High $13,182.57 | Facility | None | $2,818.38 | $4,897.79 | $13,182.57 |
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 $1,288.25 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 $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 $371.54 Median $371.54 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $131.83 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $616.60 |
Where New Jersey sits
The same service costs 7.2 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· 39th 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.