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 $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $186.21 | Professional | None | $151.36 | $165.96 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,096.48 Typical High $1,778.28 | Facility | None | $549.54 | $1,096.48 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $407.38 | Professional | None | $123.03 | $169.82 | $407.38 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $302.00 | Professional | None | $204.17 | $302.00 | $302.00 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,995.26 Typical High $5,888.44 | Facility | None | $1,096.48 | $1,995.26 | $5,888.44 |
Horizon BCBS Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $549.54 | Professional | None | $147.91 | $204.17 | $549.54 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $346.74 | Professional | None | $128.82 | $186.21 | $346.74 |
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 $74.13 Median $83.18 Typical High $91.20 | Professional | 52 · Reduced service | $74.13 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.11 Typical High $36.31 | Professional | 53 · Discontinued | $30.20 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $123.03 Typical High $134.90 | Professional | 54 · Surgery only | $112.20 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $24.55 Typical High $27.54 | Professional | 55 · Aftercare only | $22.39 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.60 Typical High $18.20 | Professional | 56 · Pre-op care only | $15.14 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $114.82 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $104.71 | $114.82 | $125.89 |
Where New Jersey sits
The same service costs 4.6 times more in Alaska 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· 40th of 51
$200
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.