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 $933.25 Median $6,309.57 Typical High $10,471.29 | Facility | None | $933.25 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,737.80 | Professional | None | $933.25 | $933.25 | $1,737.80 |
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 $812.83 Median $1,000.00 Typical High $2,511.89 | Professional | None | $812.83 | $1,000.00 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,348.96 | Professional | None | $912.01 | $1,348.96 | $1,348.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $5,011.87 Typical High $13,182.57 | Facility | None | $2,754.23 | $5,011.87 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $2,630.27 | Professional | None | $912.01 | $1,071.52 | $2,630.27 |
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 $575.44 Median $831.76 Typical High $2,238.72 | Professional | None | $575.44 | $831.76 | $2,238.72 |
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 $467.74 Median $467.74 Typical High $562.34 | Professional | 52 · Reduced service | $467.74 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $691.83 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $776.25 |
Where New Jersey sits
The same service costs 6.2 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
$1,122
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.