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 $4,466.84 Median $7,244.36 Typical High $11,748.98 | Facility | None | $4,466.84 | $7,244.36 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $575.44 | Professional | None | $489.78 | $489.78 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $3,981.07 | Facility | None | $1,318.26 | $2,754.23 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $1,318.26 | Professional | None | $436.52 | $537.03 | $1,318.26 |
Emblem Health Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $724.44 | Professional | None | $489.78 | $724.44 | $724.44 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $5,495.41 Typical High $13,489.63 | Facility | None | $3,090.30 | $5,495.41 | $13,489.63 |
Horizon BCBS Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $1,380.38 | Professional | None | $478.63 | $562.34 | $1,380.38 |
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 $309.03 Median $436.52 Typical High $1,174.90 | Professional | None | $309.03 | $436.52 | $1,174.90 |
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 $245.47 Median $245.47 Typical High $288.40 | Professional | 52 · Reduced service | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $117.49 | Professional | 53 · Discontinued | $97.72 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | 54 · Surgery only | $371.54 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $87.10 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $57.54 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $407.38 |
Where New Jersey sits
The same service costs 10.0 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
$631
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.