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 $575.44 Median $4,786.30 Typical High $10,232.93 | Facility | None | $575.44 | $4,786.30 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $707.95 | Professional | None | $512.86 | $588.84 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,089.30 Typical High $2,884.03 | Facility | None | $1,318.26 | $2,089.30 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $707.95 Typical High $1,288.25 | Professional | None | $446.68 | $707.95 | $1,288.25 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,513.56 | Professional | None | $1,096.48 | $1,445.44 | $1,513.56 |
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 $707.95 Median $1,000.00 Typical High $1,348.96 | Professional | None | $707.95 | $1,000.00 | $1,348.96 |
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 $354.81 Median $537.03 Typical High $1,202.26 | Professional | None | $354.81 | $537.03 | $1,202.26 |
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 $295.12 Typical High $354.81 | Professional | 52 · Reduced service | $257.04 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $117.49 Typical High $141.25 | Professional | 53 · Discontinued | $102.33 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $446.68 Typical High $524.81 | Professional | 54 · Surgery only | $389.05 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $89.13 Typical High $104.71 | Professional | 55 · Aftercare only | $77.62 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $58.88 Typical High $70.79 | Professional | 56 · Pre-op care only | $51.29 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $416.87 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $363.08 | $416.87 | $489.78 |
Where New Jersey sits
The same service costs 4.9 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· 49th of 51
$708
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.