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 $102.33 Median $3,548.13 Typical High $10,232.93 | Facility | None | $102.33 | $3,548.13 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $223.87 | Professional | None | $97.72 | $114.82 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $239.88 Typical High $2,691.53 | Facility | None | $131.83 | $239.88 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $302.00 | Professional | None | $104.71 | $158.49 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $269.15 | Professional | None | $177.83 | $269.15 | $269.15 |
Horizon BCBS Setting Facility Modifier None Typical Low $208.93 Median $380.19 Typical High $12,302.69 | Facility | None | $208.93 | $380.19 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $398.11 | Professional | None | $104.71 | $165.96 | $398.11 |
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 $104.71 Median $162.18 Typical High $275.42 | Professional | None | $104.71 | $162.18 | $275.42 |
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 $47.86 Median $57.54 Typical High $70.79 | Professional | 52 · Reduced service | $47.86 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $22.91 Typical High $28.18 | Professional | 53 · Discontinued | $19.50 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $85.11 Typical High $107.15 | Professional | 54 · Surgery only | $72.44 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.98 Typical High $21.38 | Professional | 55 · Aftercare only | $14.45 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.48 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.77 | $11.48 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $79.43 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $67.61 | $79.43 | $100.00 |
Where New Jersey sits
The same service costs 3.7 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· 30th of 51
$166
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.