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 $4,365.16 Median $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $954.99 | Professional | None | $676.08 | $676.08 | $954.99 |
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 $537.03 Median $870.96 Typical High $1,737.80 | Professional | None | $537.03 | $870.96 | $1,737.80 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,348.96 | Professional | None | $977.24 | $1,318.26 | $1,348.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $10,964.78 | Facility | None | $1,995.26 | $3,548.13 | $10,964.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,513.56 | Professional | None | $912.01 | $1,071.52 | $1,513.56 |
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 $436.52 Median $575.44 Typical High $1,548.82 | Professional | None | $436.52 | $575.44 | $1,548.82 |
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 $338.84 Median $338.84 Typical High $416.87 | Professional | 52 · Reduced service | $338.84 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 53 · Discontinued | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $630.96 | Professional | 54 · Surgery only | $512.86 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $125.89 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $83.18 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $588.84 |
Where New Jersey sits
The same service costs 7.1 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
$1,072
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.