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 $251.19 Median $3,467.37 Typical High $10,232.93 | Facility | None | $251.19 | $3,467.37 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $416.87 Typical High $602.56 | Professional | None | $245.47 | $416.87 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $281.84 Typical High $398.11 | Facility | None | $181.97 | $281.84 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $338.84 Typical High $575.44 | Professional | None | $199.53 | $338.84 | $575.44 |
Emblem Health Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $707.95 | Professional | None | $537.03 | $707.95 | $707.95 |
Horizon BCBS Setting Facility Modifier None Typical Low $257.04 Median $457.09 Typical High $1,202.26 | Facility | None | $257.04 | $457.09 | $1,202.26 |
Horizon BCBS Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $660.69 | Professional | None | $245.47 | $457.09 | $660.69 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,348.96 Typical High $3,890.45 | Facility | None | $309.03 | $1,348.96 | $3,890.45 |
United Setting Professional Modifier None Typical Low $173.78 Median $338.84 Typical High $467.74 | Professional | None | $173.78 | $338.84 | $467.74 |
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 $123.03 Median $173.78 Typical High $208.93 | Professional | 52 · Reduced service | $123.03 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $69.18 Typical High $83.18 | Professional | 53 · Discontinued | $48.98 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $257.04 Typical High $316.23 | Professional | 54 · Surgery only | $181.97 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $52.48 Typical High $63.10 | Professional | 55 · Aftercare only | $36.31 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $34.67 Typical High $41.69 | Professional | 56 · Pre-op care only | $24.55 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $239.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $169.82 | $239.88 | $295.12 |
Where New Jersey sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 42nd of 51
$372
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.