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 $138.04 Median $4,570.88 Typical High $10,000.00 | Facility | None | $138.04 | $4,570.88 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $239.88 | Professional | None | $128.82 | $204.17 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $346.74 Typical High $2,691.53 | Facility | None | $186.21 | $346.74 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $457.09 | Professional | None | $95.50 | $169.82 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $354.81 | Professional | None | $234.42 | $354.81 | $354.81 |
Horizon BCBS Setting Facility Modifier None Typical Low $288.40 Median $537.03 Typical High $2,187.76 | Facility | None | $288.40 | $537.03 | $2,187.76 |
Horizon BCBS Setting Professional Modifier None Typical Low $128.82 Median $251.19 Typical High $588.84 | Professional | None | $128.82 | $251.19 | $588.84 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,380.38 Typical High $3,890.45 | Facility | None | $309.03 | $1,380.38 | $3,890.45 |
United Setting Professional Modifier None Typical Low $81.28 Median $144.54 Typical High $371.54 | Professional | None | $81.28 | $144.54 | $371.54 |
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 $63.10 Median $95.50 Typical High $112.20 | Professional | 52 · Reduced service | $63.10 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $44.67 | Professional | 53 · Discontinued | $25.70 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $141.25 Typical High $169.82 | Professional | 54 · Surgery only | $95.50 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.88 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $131.83 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $89.13 | $131.83 | $158.49 |
Where New Jersey sits
The same service costs 3.5 times more in Wisconsin 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· 41st of 51
$209
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.