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 $831.76 Median $6,918.31 Typical High $12,022.64 | Facility | None | $831.76 | $6,918.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $1,513.56 | Professional | None | $794.33 | $831.76 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $6,309.57 Typical High $11,220.18 | Facility | None | $1,995.26 | $6,309.57 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $2,137.96 | Professional | None | $724.44 | $891.25 | $2,137.96 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,148.15 | Professional | None | $776.25 | $1,148.15 | $1,148.15 |
Horizon BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $14,125.38 Typical High $39,810.72 | Facility | None | $7,943.28 | $14,125.38 | $39,810.72 |
Horizon BCBS Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $2,290.87 | Professional | None | $870.96 | $933.25 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,786.30 | $11,481.54 |
United Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,862.09 | Professional | None | $724.44 | $954.99 | $1,862.09 |
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 $389.05 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $389.05 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $707.95 | Professional | 54 · Surgery only | $575.44 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $660.69 |
Where New Jersey sits
The same service costs 11.0 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· 29th of 51
$1,122
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.