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 $977.24 Median $6,309.57 Typical High $10,471.29 | Facility | None | $977.24 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,778.28 | Professional | None | $977.24 | $977.24 | $1,778.28 |
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 $831.76 Median $1,023.29 Typical High $2,570.40 | Professional | None | $831.76 | $1,023.29 | $2,570.40 |
Emblem Health Setting Professional Modifier None Typical Low $933.25 Median $1,380.38 Typical High $1,380.38 | Professional | None | $933.25 | $1,380.38 | $1,380.38 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $5,011.87 Typical High $14,454.40 | Facility | None | $2,754.23 | $5,011.87 | $14,454.40 |
Horizon BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $2,691.53 | Professional | None | $933.25 | $1,096.48 | $2,691.53 |
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 $588.84 Median $851.14 Typical High $2,290.87 | Professional | None | $588.84 | $851.14 | $2,290.87 |
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 $489.78 Median $489.78 Typical High $588.84 | Professional | 52 · Reduced service | $489.78 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $870.96 | Professional | 54 · Surgery only | $741.31 | $741.31 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $812.83 |
Where New Jersey sits
The same service costs 5.9 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
$1,175
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.