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 $2,754.23 Median $7,079.46 Typical High $11,748.98 | Facility | None | $2,754.23 | $7,079.46 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $549.54 | Professional | None | $239.88 | $295.12 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $389.05 Typical High $1,659.59 | Facility | None | $223.87 | $389.05 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $436.52 | Professional | None | $194.98 | $251.19 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $501.19 | Professional | None | $380.19 | $501.19 | $501.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $323.59 Median $562.34 Typical High $2,089.30 | Facility | None | $323.59 | $562.34 | $2,089.30 |
Horizon BCBS Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $549.54 | Professional | None | $239.88 | $354.81 | $549.54 |
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 $169.82 Median $245.47 Typical High $331.13 | Professional | None | $169.82 | $245.47 | $331.13 |
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 $120.23 Median $147.91 Typical High $162.18 | Professional | 52 · Reduced service | $120.23 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $58.88 Typical High $64.57 | Professional | 53 · Discontinued | $47.86 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $218.78 Typical High $239.88 | Professional | 54 · Surgery only | $177.83 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $43.65 Typical High $47.86 | Professional | 55 · Aftercare only | $35.48 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $29.51 Typical High $32.36 | Professional | 56 · Pre-op care only | $23.99 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $204.17 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $165.96 | $204.17 | $223.87 |
Where New Jersey sits
The same service costs 5.2 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· 43rd of 51
$288
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.