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 $1,737.80 | Professional | None | $977.24 | $977.24 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $5,754.40 Typical High $10,964.78 | Facility | None | $1,174.90 | $5,754.40 | $10,964.78 |
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 $954.99 Median $1,348.96 Typical High $1,348.96 | Professional | None | $954.99 | $1,348.96 | $1,348.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $14,125.38 Typical High $35,481.34 | Facility | None | $6,918.31 | $14,125.38 | $35,481.34 |
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 $7,943.28 | Facility | None | $1,288.25 | $3,388.44 | $7,943.28 |
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 $489.78 Median $489.78 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $245.47 | Professional | 53 · Discontinued | $194.98 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $912.01 | Professional | 54 · Surgery only | $741.31 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $181.97 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $123.03 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $851.14 |
Where New Jersey sits
The same service costs 6.3 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
$1,175
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.