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 $2,089.30 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,089.30 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $2,818.38 | Facility | None | $1,174.90 | $1,995.26 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $4,466.84 | Professional | None | $2,041.74 | $2,238.72 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,187.76 | $2,951.21 | $2,951.21 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $7,244.36 Typical High $11,748.98 | Facility | None | $4,073.80 | $7,244.36 | $11,748.98 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $2,344.23 Typical High $3,630.78 | Professional | None | $2,238.72 | $2,344.23 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,220.18 | Facility | None | $1,621.81 | $4,786.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,819.70 | $2,951.21 |
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 $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,047.13 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $416.87 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,584.89 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,621.81 | $1,621.81 |
Where New Jersey sits
The same service costs 19.5 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· 40th of 51
$2,239
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.