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 $4,466.84 Median $9,549.93 Typical High $14,125.38 | Facility | None | $4,466.84 | $9,549.93 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,122.02 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $6,165.95 Typical High $11,220.18 | Facility | None | $2,511.89 | $6,165.95 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $2,754.23 | Professional | None | $977.24 | $1,174.90 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,548.82 | $1,548.82 |
Horizon BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $13,489.63 Typical High $39,810.72 | Facility | None | $7,585.78 | $13,489.63 | $39,810.72 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $3,019.95 | Professional | None | $1,071.52 | $1,258.93 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,000.00 | $1,288.25 | $2,570.40 |
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 $537.03 Median $562.34 Typical High $645.65 | Professional | 52 · Reduced service | $537.03 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $263.03 | Professional | 53 · Discontinued | $213.80 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $977.24 | Professional | 54 · Surgery only | $794.33 | $831.76 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $165.96 Typical High $194.98 | Professional | 55 · Aftercare only | $158.49 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $128.82 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $912.01 |
Where New Jersey sits
The same service costs 8.7 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
$1,479
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.