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 $144.54 Median $3,548.13 Typical High $10,232.93 | Facility | None | $144.54 | $3,548.13 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $275.42 | Professional | None | $131.83 | $213.80 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $281.84 Typical High $407.38 | Facility | None | $186.21 | $281.84 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $478.63 | Professional | None | $100.00 | $181.97 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $380.19 | Professional | None | $125.89 | $147.91 | $380.19 |
Horizon BCBS Setting Facility Modifier None Typical Low $331.13 Median $588.84 Typical High $2,884.03 | Facility | None | $331.13 | $588.84 | $2,884.03 |
Horizon BCBS Setting Professional Modifier None Typical Low $134.90 Median $269.15 Typical High $630.96 | Professional | None | $134.90 | $269.15 | $630.96 |
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 $83.18 Median $154.88 Typical High $407.38 | Professional | None | $83.18 | $154.88 | $407.38 |
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 $66.07 Median $100.00 Typical High $117.49 | Professional | 52 · Reduced service | $66.07 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $26.30 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $97.72 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $19.50 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.95 Typical High $23.44 | Professional | 56 · Pre-op care only | $13.18 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $91.20 | $141.25 | $165.96 |
Where New Jersey sits
The same service costs 4.6 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· 42nd of 51
$219
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.