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 $660.69 Median $5,248.07 Typical High $12,302.69 | Facility | None | $660.69 | $5,248.07 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $794.33 | Professional | None | $660.69 | $691.83 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $3,467.37 Typical High $5,248.07 | Facility | None | $1,548.82 | $3,467.37 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $1,288.25 | Professional | None | $537.03 | $645.65 | $1,288.25 |
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 $2,041.74 Median $3,801.89 Typical High $12,589.25 | Facility | None | $2,041.74 | $3,801.89 | $12,589.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,288.25 | Professional | None | $549.54 | $794.33 | $1,288.25 |
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 $398.11 Median $537.03 Typical High $851.14 | Professional | None | $398.11 | $537.03 | $851.14 |
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 $346.74 Typical High $398.11 | Professional | 52 · Reduced service | $331.13 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $131.83 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $602.56 | Professional | 54 · Surgery only | $501.19 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $120.23 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $562.34 |
Where New Jersey sits
The same service costs 6.2 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· 41st of 51
$661
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.