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 $208.93 Median $4,786.30 Typical High $10,232.93 | Facility | None | $208.93 | $4,786.30 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $407.38 | Professional | None | $194.98 | $218.78 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,949.84 Typical High $2,884.03 | Facility | None | $933.25 | $1,949.84 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $537.03 | Professional | None | $190.55 | $275.42 | $537.03 |
Emblem Health Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $446.68 | Professional | None | $295.12 | $446.68 | $446.68 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $3,019.95 Typical High $7,762.47 | Facility | None | $1,659.59 | $3,019.95 | $7,762.47 |
Horizon BCBS Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $724.44 | Professional | None | $199.53 | $288.40 | $724.44 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $501.19 | Professional | None | $199.53 | $295.12 | $501.19 |
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 $97.72 Median $109.65 Typical High $125.89 | Professional | 52 · Reduced service | $97.72 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $44.67 Typical High $50.12 | Professional | 53 · Discontinued | $38.90 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $165.96 Typical High $190.55 | Professional | 54 · Surgery only | $144.54 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.11 Typical High $38.02 | Professional | 55 · Aftercare only | $28.84 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $19.50 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $154.88 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $134.90 | $154.88 | $177.83 |
Where New Jersey sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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· 37th of 51
$288
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.