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 $4,365.16 Median $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $758.58 | Professional | None | $407.38 | $407.38 | $758.58 |
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 $363.08 Median $446.68 Typical High $1,096.48 | Professional | None | $363.08 | $446.68 | $1,096.48 |
Emblem Health Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $602.56 | Professional | None | $407.38 | $602.56 | $602.56 |
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 $398.11 Median $467.74 Typical High $1,148.15 | Professional | None | $398.11 | $467.74 | $1,148.15 |
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 $257.04 Median $363.08 Typical High $1,000.00 | Professional | None | $257.04 | $363.08 | $1,000.00 |
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 $204.17 Median $204.17 Typical High $239.88 | Professional | 52 · Reduced service | $204.17 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | 53 · Discontinued | $81.28 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | 54 · Surgery only | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $331.13 |
Where New Jersey sits
The same service costs 6.0 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· 38th of 51
$537
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.