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 $354.81 Median $5,370.32 Typical High $10,471.29 | Facility | None | $354.81 | $5,370.32 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $691.83 | Professional | None | $354.81 | $354.81 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $2,818.38 Typical High $4,168.69 | Facility | None | $1,819.70 | $2,818.38 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $912.01 | Professional | None | $331.13 | $416.87 | $912.01 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $524.81 Typical High $524.81 | Professional | None | $363.08 | $524.81 | $524.81 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $12,302.69 | Facility | None | $2,691.53 | $4,786.30 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $1,000.00 | Professional | None | $354.81 | $416.87 | $1,000.00 |
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 $331.13 Median $436.52 Typical High $851.14 | Professional | None | $331.13 | $436.52 | $851.14 |
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 $177.83 Median $177.83 Typical High $218.78 | Professional | 52 · Reduced service | $177.83 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $87.10 | Professional | 53 · Discontinued | $70.79 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $263.03 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $53.70 Typical High $64.57 | Professional | 55 · Aftercare only | $52.48 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $43.65 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $251.19 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $245.47 | $251.19 | $302.00 |
Where New Jersey sits
The same service costs 7.1 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· 32nd of 51
$513
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.