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 $177.83 Median $3,548.13 Typical High $10,232.93 | Facility | None | $177.83 | $3,548.13 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $354.81 | Professional | None | $169.82 | $190.55 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,238.72 Typical High $3,890.45 | Facility | None | $691.83 | $2,238.72 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $478.63 | Professional | None | $169.82 | $239.88 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $389.05 | Professional | None | $263.03 | $389.05 | $389.05 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $13,182.57 | Facility | None | $2,691.53 | $4,786.30 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $630.96 | Professional | None | $173.78 | $257.04 | $630.96 |
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 $173.78 Median $257.04 Typical High $436.52 | Professional | None | $173.78 | $257.04 | $436.52 |
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 $85.11 Median $95.50 Typical High $109.65 | Professional | 52 · Reduced service | $85.11 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.02 Typical High $43.65 | Professional | 53 · Discontinued | $33.88 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $144.54 Typical High $162.18 | Professional | 54 · Surgery only | $125.89 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.84 Typical High $33.11 | Professional | 55 · Aftercare only | $25.12 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.05 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.98 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $134.90 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $117.49 | $134.90 | $151.36 |
Where New Jersey sits
The same service costs 4.4 times more in Alaska 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· 35th of 51
$257
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.