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 $602.56 Median $4,786.30 Typical High $10,471.29 | Facility | None | $602.56 | $4,786.30 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $933.25 | Professional | None | $512.86 | $616.60 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,949.84 Typical High $2,884.03 | Facility | None | $933.25 | $1,949.84 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $691.83 Typical High $1,230.27 | Professional | None | $407.38 | $691.83 | $1,230.27 |
Emblem Health Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,288.25 | Professional | None | $912.01 | $1,230.27 | $1,288.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $2,951.21 Typical High $7,762.47 | Facility | None | $1,659.59 | $2,951.21 | $7,762.47 |
Horizon BCBS Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,412.54 | Professional | None | $645.65 | $912.01 | $1,412.54 |
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 $302.00 Median $478.63 Typical High $1,122.02 | Professional | None | $302.00 | $478.63 | $1,122.02 |
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 $257.04 Median $309.03 Typical High $354.81 | Professional | 52 · Reduced service | $257.04 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $123.03 Typical High $144.54 | Professional | 53 · Discontinued | $102.33 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $457.09 Typical High $537.03 | Professional | 54 · Surgery only | $389.05 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $107.15 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $61.66 Typical High $72.44 | Professional | 56 · Pre-op care only | $51.29 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $426.58 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $363.08 | $426.58 | $501.19 |
Where New Jersey sits
The same service costs 4.5 times more in Alaska than in Texas. 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
$724
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.