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 $2,754.23 Median $5,888.44 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $741.31 | Professional | None | $398.11 | $575.44 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $3,467.37 Typical High $6,760.83 | Facility | None | $933.25 | $3,467.37 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $616.60 Typical High $1,230.27 | Professional | None | $363.08 | $616.60 | $1,230.27 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | None | $776.25 | $1,047.13 | $1,047.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,511.38 Typical High $22,387.21 | Facility | None | $4,677.35 | $8,511.38 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $363.08 Median $707.95 Typical High $1,174.90 | Professional | None | $363.08 | $707.95 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $275.42 Median $489.78 Typical High $776.25 | Professional | None | $275.42 | $489.78 | $776.25 |
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 $199.53 Median $281.84 Typical High $371.54 | Professional | 52 · Reduced service | $199.53 | $281.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $112.20 Typical High $151.36 | Professional | 53 · Discontinued | $79.43 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $426.58 Typical High $562.34 | Professional | 54 · Surgery only | $295.12 | $426.58 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $85.11 Typical High $112.20 | Professional | 55 · Aftercare only | $58.88 | $85.11 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $56.23 Typical High $74.13 | Professional | 56 · Pre-op care only | $39.81 | $56.23 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $398.11 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $275.42 | $398.11 | $524.81 |
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· 42nd of 51
$550
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.