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 $4,466.84 Median $7,244.36 Typical High $11,748.98 | Facility | None | $4,466.84 | $7,244.36 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $933.25 | Professional | None | $724.44 | $724.44 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,090.30 Typical High $4,466.84 | Facility | None | $1,318.26 | $3,090.30 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $954.99 Typical High $1,737.80 | Professional | None | $588.84 | $954.99 | $1,737.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,412.54 | $1,479.11 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $5,623.41 Typical High $14,454.40 | Facility | None | $3,019.95 | $5,623.41 | $14,454.40 |
Horizon BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,698.24 | Professional | None | $977.24 | $1,148.15 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $1,659.59 | Professional | None | $478.63 | $630.96 | $1,659.59 |
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 $363.08 Median $363.08 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $363.08 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $616.60 |
Where New Jersey sits
The same service costs 8.3 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· 33rd of 51
$1,148
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.