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 $194.98 Median $4,466.84 Typical High $9,772.37 | Facility | None | $194.98 | $4,466.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $269.15 | Professional | None | $194.98 | $234.42 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $933.25 Typical High $2,187.76 | Facility | None | $512.86 | $933.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $436.52 | Professional | None | $229.09 | $316.23 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $446.68 | Professional | None | $323.59 | $446.68 | $446.68 |
Horizon BCBS Setting Facility Modifier None Typical Low $831.76 Median $1,479.11 Typical High $3,630.78 | Facility | None | $831.76 | $1,479.11 | $3,630.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $501.19 | Professional | None | $177.83 | $275.42 | $501.19 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $371.54 | Professional | None | $109.65 | $165.96 | $371.54 |
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 $97.72 Median $112.20 Typical High $120.23 | Professional | 52 · Reduced service | $97.72 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $44.67 Typical High $47.86 | Professional | 53 · Discontinued | $38.90 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $169.82 Typical High $181.97 | Professional | 54 · Surgery only | $144.54 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.88 Typical High $36.31 | Professional | 55 · Aftercare only | $28.84 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.39 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.50 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $158.49 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $134.90 | $158.49 | $169.82 |
Where New Jersey sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 39th of 51
$240
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.