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 $120.23 Median $4,786.30 Typical High $10,232.93 | Facility | None | $120.23 | $4,786.30 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $208.93 | Professional | None | $114.82 | $131.83 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $194.98 Typical High $2,691.53 | Facility | None | $104.71 | $194.98 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $331.13 | Professional | None | $100.00 | $162.18 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $263.03 | Professional | None | $177.83 | $263.03 | $263.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $173.78 Median $316.23 Typical High $12,302.69 | Facility | None | $173.78 | $316.23 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $407.38 | Professional | None | $109.65 | $173.78 | $407.38 |
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 $109.65 Median $165.96 Typical High $288.40 | Professional | None | $109.65 | $165.96 | $288.40 |
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 $57.54 Median $66.07 Typical High $72.44 | Professional | 52 · Reduced service | $57.54 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.30 Typical High $28.84 | Professional | 53 · Discontinued | $22.91 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $100.00 Typical High $107.15 | Professional | 54 · Surgery only | $87.10 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.95 Typical High $21.88 | Professional | 55 · Aftercare only | $17.38 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.18 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.48 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $93.33 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $81.28 | $93.33 | $100.00 |
Where New Jersey sits
The same service costs 3.6 times more in Wisconsin 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· 33rd of 51
$174
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.