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 $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,344.23 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $18,197.01 Typical High $31,622.78 | Facility | None | $1,995.26 | $18,197.01 | $31,622.78 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $5,370.32 | Professional | None | $2,570.40 | $3,019.95 | $5,370.32 |
Emblem Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,890.45 Typical High $3,890.45 | Professional | None | $2,884.03 | $3,890.45 | $3,890.45 |
Horizon BCBS Setting Facility Modifier None Typical Low $13,803.84 Median $24,547.09 Typical High $70,794.58 | Facility | None | $13,803.84 | $24,547.09 | $70,794.58 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $3,090.30 Typical High $4,265.80 | Professional | None | $2,951.21 | $3,090.30 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,495.41 Typical High $13,803.84 | Facility | None | $1,659.59 | $5,495.41 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $3,801.89 | Professional | None | $1,862.09 | $2,344.23 | $3,801.89 |
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 $1,174.90 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,174.90 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $478.63 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,778.28 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $354.81 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $234.42 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,737.80 | $1,737.80 |
Where New Jersey sits
The same service costs 20.0 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· 38th of 51
$2,884
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.