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 $141.25 Median $144.54 Typical High $169.82 | Professional | None | $141.25 | $144.54 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $199.53 Typical High $1,659.59 | Facility | None | $112.20 | $199.53 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $234.42 | Professional | None | $117.49 | $128.82 | $234.42 |
Emblem Health Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $257.04 | Professional | None | $194.98 | $257.04 | $257.04 |
Horizon BCBS Setting Facility Modifier None Typical Low $162.18 Median $288.40 Typical High $9,549.93 | Facility | None | $162.18 | $288.40 | $9,549.93 |
Horizon BCBS Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $263.03 | Professional | None | $144.54 | $181.97 | $263.03 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $177.83 | Professional | None | $104.71 | $134.90 | $177.83 |
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 $70.79 Median $72.44 Typical High $79.43 | Professional | 52 · Reduced service | $70.79 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $29.51 Typical High $31.62 | Professional | 53 · Discontinued | $28.18 | $29.51 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $109.65 Typical High $120.23 | Professional | 54 · Surgery only | $104.71 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.88 Typical High $23.99 | Professional | 55 · Aftercare only | $20.89 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.45 Typical High $15.85 | Professional | 56 · Pre-op care only | $14.13 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $102.33 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $97.72 | $102.33 | $112.20 |
Where New Jersey sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 49th of 51
$145
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.