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 $5,888.44 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $257.04 | Professional | None | $128.82 | $218.78 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,023.29 Typical High $2,187.76 | Facility | None | $575.44 | $1,023.29 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $363.08 | Professional | None | $107.15 | $213.80 | $363.08 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $446.68 | Professional | None | $331.13 | $446.68 | $446.68 |
Horizon BCBS Setting Facility Modifier None Typical Low $851.14 Median $1,513.56 Typical High $3,715.35 | Facility | None | $851.14 | $1,513.56 | $3,715.35 |
Horizon BCBS Setting Professional Modifier None Typical Low $131.83 Median $288.40 Typical High $416.87 | Professional | None | $131.83 | $288.40 | $416.87 |
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 $97.72 Median $208.93 Typical High $288.40 | Professional | None | $97.72 | $208.93 | $288.40 |
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 $64.57 Median $104.71 Typical High $128.82 | Professional | 52 · Reduced service | $64.57 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $41.69 Typical High $51.29 | Professional | 53 · Discontinued | $25.70 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $158.49 Typical High $194.98 | Professional | 54 · Surgery only | $95.50 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $31.62 Typical High $38.90 | Professional | 55 · Aftercare only | $19.05 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.88 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $147.91 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $89.13 | $147.91 | $181.97 |
Where New Jersey sits
The same service costs 4.7 times more in Alaska than in Virginia. 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
$234
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.