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 $5,754.40 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,754.40 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $213.80 | Professional | None | $117.49 | $194.98 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $346.74 Typical High $2,691.53 | Facility | None | $190.55 | $346.74 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $436.52 | Professional | None | $91.20 | $165.96 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $346.74 | Professional | None | $229.09 | $346.74 | $346.74 |
Horizon BCBS Setting Facility Modifier None Typical Low $302.00 Median $549.54 Typical High $6,309.57 | Facility | None | $302.00 | $549.54 | $6,309.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $120.23 Median $239.88 Typical High $562.34 | Professional | None | $120.23 | $239.88 | $562.34 |
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 $75.86 Median $141.25 Typical High $363.08 | Professional | None | $75.86 | $141.25 | $363.08 |
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 $58.88 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $58.88 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $23.44 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $134.90 Typical High $158.49 | Professional | 54 · Surgery only | $89.13 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $17.78 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $11.75 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $125.89 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $83.18 | $125.89 | $147.91 |
Where New Jersey sits
The same service costs 3.9 times more in Oklahoma 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· 44th of 51
$204
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.