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 $102.33 Median $158.49 Typical High $245.47 | Professional | None | $102.33 | $158.49 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,659.59 Typical High $2,884.03 | Facility | None | $691.83 | $1,659.59 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $234.42 | Professional | None | $87.10 | $144.54 | $234.42 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $288.40 | Professional | None | $218.78 | $288.40 | $288.40 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,089.30 Median $3,630.78 Typical High $8,709.64 | Facility | None | $2,089.30 | $3,630.78 | $8,709.64 |
Horizon BCBS Setting Professional Modifier None Typical Low $107.15 Median $186.21 Typical High $269.15 | Professional | None | $107.15 | $186.21 | $269.15 |
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 $79.43 Median $138.04 Typical High $190.55 | Professional | None | $79.43 | $138.04 | $190.55 |
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 $51.29 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $51.29 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $27.54 Typical High $31.62 | Professional | 53 · Discontinued | $20.42 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $104.71 Typical High $120.23 | Professional | 54 · Surgery only | $77.62 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $15.49 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.23 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $97.72 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $72.44 | $97.72 | $112.20 |
Where New Jersey sits
The same service costs 4.8 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· 45th of 51
$151
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.