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 $7,244.36 Typical High $11,748.98 | Facility | None | $4,466.84 | $7,244.36 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,122.02 | Professional | None | $588.84 | $588.84 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,981.07 Typical High $6,760.83 | Facility | None | $1,318.26 | $3,981.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $1,513.56 | Professional | None | $398.11 | $645.65 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $831.76 | Professional | None | $562.34 | $831.76 | $831.76 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,317.64 Typical High $22,908.68 | Facility | None | $4,677.35 | $8,317.64 | $22,908.68 |
Horizon BCBS Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $1,621.81 | Professional | None | $562.34 | $660.69 | $1,621.81 |
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 $407.38 Median $602.56 Typical High $1,258.93 | Professional | None | $407.38 | $602.56 | $1,258.93 |
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 $295.12 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $295.12 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | 53 · Discontinued | $117.49 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $478.63 | Professional | 54 · Surgery only | $446.68 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $95.50 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $446.68 |
Where New Jersey sits
The same service costs 8.1 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· 35th of 51
$794
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.