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 $660.69 Median $660.69 Typical High $831.76 | Professional | None | $660.69 | $660.69 | $831.76 |
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 $537.03 Median $870.96 Typical High $1,584.89 | Professional | None | $537.03 | $870.96 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,348.96 | Professional | None | $954.99 | $1,288.25 | $1,348.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $3,019.95 Typical High $8,317.64 | Facility | None | $1,584.89 | $3,019.95 | $8,317.64 |
Horizon BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,479.11 | Professional | None | $891.25 | $1,047.13 | $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 $436.52 Median $562.34 Typical High $1,513.56 | Professional | None | $436.52 | $562.34 | $1,513.56 |
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 $331.13 Median $331.13 Typical High $407.38 | Professional | 52 · Reduced service | $331.13 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $162.18 | Professional | 53 · Discontinued | $131.83 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $616.60 | Professional | 54 · Surgery only | $489.78 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $123.03 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $575.44 |
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· 29th of 51
$1,047
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.