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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $208.93 | Professional | None | $162.18 | $162.18 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $2,884.03 | Facility | None | $1,318.26 | $2,089.30 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $457.09 | Professional | None | $162.18 | $199.53 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $251.19 | Professional | None | $173.78 | $251.19 | $251.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,548.13 | $10,964.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $478.63 | Professional | None | $169.82 | $199.53 | $478.63 |
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 $158.49 Median $208.93 Typical High $407.38 | Professional | None | $158.49 | $208.93 | $407.38 |
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 $81.28 Median $81.28 Typical High $104.71 | Professional | 52 · Reduced service | $81.28 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $41.69 | Professional | 53 · Discontinued | $32.36 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $158.49 | Professional | 54 · Surgery only | $123.03 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $31.62 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $147.91 |
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· 32nd of 51
$245
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.