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 $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $912.01 Typical High $954.99 | Professional | None | $891.25 | $912.01 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $3,715.35 Typical High $6,760.83 | Facility | None | $1,995.26 | $3,715.35 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,905.46 | Professional | None | $870.96 | $1,023.29 | $1,905.46 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,318.26 | Professional | None | $977.24 | $1,318.26 | $1,318.26 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $8,128.31 Typical High $22,387.21 | Facility | None | $4,466.84 | $8,128.31 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,479.11 | Professional | None | $870.96 | $1,047.13 | $1,479.11 |
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 $630.96 Median $794.33 Typical High $1,288.25 | Professional | None | $630.96 | $794.33 | $1,288.25 |
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 $446.68 Median $457.09 Typical High $478.63 | Professional | 52 · Reduced service | $446.68 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $190.55 | Professional | 53 · Discontinued | $177.83 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $707.95 | Professional | 54 · Surgery only | $676.08 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $141.25 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $95.50 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $660.69 |
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· 43rd of 51
$912
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.