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 $426.58 Median $7,244.36 Typical High $12,882.50 | Facility | None | $426.58 | $7,244.36 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $794.33 | Professional | None | $426.58 | $426.58 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $4,786.30 Typical High $6,918.31 | Facility | None | $2,511.89 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $1,148.15 | Professional | None | $380.19 | $489.78 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $630.96 | Professional | None | $426.58 | $630.96 | $630.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $8,317.64 Typical High $22,908.68 | Facility | None | $4,466.84 | $8,317.64 | $22,908.68 |
Horizon BCBS Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $1,202.26 | Professional | None | $416.87 | $489.78 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $1,047.13 | Professional | None | $269.15 | $380.19 | $1,047.13 |
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 $213.80 Median $213.80 Typical High $251.19 | Professional | 52 · Reduced service | $213.80 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | 53 · Discontinued | $85.11 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | 54 · Surgery only | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $354.81 |
Where New Jersey sits
The same service costs 9.5 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
$562
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.