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 $4,365.16 Median $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $912.01 | Professional | None | $741.31 | $776.25 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $3,981.07 Typical High $7,079.46 | Facility | None | $1,995.26 | $3,981.07 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,949.84 | Professional | None | $676.08 | $812.83 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,096.48 | Professional | None | $776.25 | $1,096.48 | $1,096.48 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $10,964.78 Typical High $28,183.83 | Facility | None | $5,888.44 | $10,964.78 | $28,183.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,995.26 | Professional | None | $724.44 | $851.14 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,737.80 | Professional | None | $691.83 | $912.01 | $1,737.80 |
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 $363.08 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $549.54 | $616.60 |
Where New Jersey sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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
$955
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.