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 $7,079.46 Typical High $11,748.98 | Facility | None | $4,365.16 | $7,079.46 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,862.09 | Professional | None | $1,698.24 | $1,698.24 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $4,677.35 Typical High $8,511.38 | Facility | None | $1,995.26 | $4,677.35 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $3,548.13 | Professional | None | $1,584.89 | $1,819.70 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,737.80 | $2,238.72 | $2,238.72 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $7,585.78 Typical High $22,387.21 | Facility | None | $4,168.69 | $7,585.78 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,548.82 | $1,862.09 | $2,691.53 |
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 $1,071.52 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,380.38 | $2,290.87 |
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 $851.14 Median $851.14 Typical High $933.25 | Professional | 52 · Reduced service | $851.14 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $371.54 | Professional | 53 · Discontinued | $338.84 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $281.84 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $186.21 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,318.26 |
Where New Jersey sits
The same service costs 20.4 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
$1,698
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.