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 $457.09 Median $6,760.83 Typical High $11,481.54 | Facility | None | $457.09 | $6,760.83 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $831.76 | Professional | None | $457.09 | $489.78 | $831.76 |
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 $398.11 Median $501.19 Typical High $1,202.26 | Professional | None | $398.11 | $501.19 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $660.69 | Professional | None | $478.63 | $660.69 | $660.69 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $2,630.27 | $5,011.87 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $1,288.25 | Professional | None | $436.52 | $512.86 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $1,096.48 | Professional | None | $281.84 | $398.11 | $1,096.48 |
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 $229.09 Median $229.09 Typical High $269.15 | Professional | 52 · Reduced service | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | 53 · Discontinued | $91.20 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $338.84 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $53.70 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $371.54 |
Where New Jersey sits
The same service costs 8.7 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
$589
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.