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 $302.00 Median $4,570.88 Typical High $10,471.29 | Facility | None | $302.00 | $4,570.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $398.11 | Professional | None | $302.00 | $302.00 | $398.11 |
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 $331.13 Median $371.54 Typical High $831.76 | Professional | None | $331.13 | $371.54 | $831.76 |
Emblem Health Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $512.86 | Professional | None | $371.54 | $512.86 | $512.86 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,570.88 Typical High $13,182.57 | Facility | None | $2,511.89 | $4,570.88 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $912.01 | Professional | None | $331.13 | $389.05 | $912.01 |
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 $302.00 Median $416.87 Typical High $776.25 | Professional | None | $302.00 | $416.87 | $776.25 |
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 $151.36 Median $151.36 Typical High $199.53 | Professional | 52 · Reduced service | $151.36 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $79.43 | Professional | 53 · Discontinued | $60.26 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $295.12 | Professional | 54 · Surgery only | $229.09 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $60.26 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $275.42 |
Where New Jersey sits
The same service costs 8.5 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· 34th of 51
$447
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.