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 $338.84 Median $4,570.88 Typical High $10,000.00 | Facility | None | $338.84 | $4,570.88 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $741.31 | Professional | None | $323.59 | $354.81 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $630.96 Typical High $2,187.76 | Facility | None | $363.08 | $630.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $549.54 | Professional | None | $275.42 | $323.59 | $549.54 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $630.96 | Professional | None | $478.63 | $630.96 | $630.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $489.78 Median $912.01 Typical High $2,089.30 | Facility | None | $489.78 | $912.01 | $2,089.30 |
Horizon BCBS Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $645.65 | Professional | None | $346.74 | $446.68 | $645.65 |
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 $245.47 Median $323.59 Typical High $416.87 | Professional | None | $245.47 | $323.59 | $416.87 |
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 $162.18 Median $177.83 Typical High $190.55 | Professional | 52 · Reduced service | $162.18 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $75.86 | Professional | 53 · Discontinued | $64.57 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $288.40 | Professional | 54 · Surgery only | $245.47 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $57.54 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $38.02 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $269.15 |
Where New Jersey sits
The same service costs 5.6 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· 44th of 51
$355
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.