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 $645.65 Median $6,309.57 Typical High $10,471.29 | Facility | None | $645.65 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $812.83 | Professional | None | $645.65 | $645.65 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $3,019.95 | Facility | None | $1,047.13 | $2,089.30 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $851.14 Typical High $1,621.81 | Professional | None | $524.81 | $851.14 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,288.25 | Professional | None | $933.25 | $1,258.93 | $1,288.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $3,388.44 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,388.44 | $10,964.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,479.11 | Professional | None | $870.96 | $1,023.29 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $1,479.11 | Professional | None | $426.58 | $549.54 | $1,479.11 |
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 $323.59 Median $323.59 Typical High $398.11 | Professional | 52 · Reduced service | $323.59 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $158.49 | Professional | 53 · Discontinued | $128.82 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $602.56 | Professional | 54 · Surgery only | $478.63 | $478.63 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $79.43 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $562.34 |
Where New Jersey sits
The same service costs 7.6 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· 31st of 51
$1,023
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.