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 $4,466.84 Median $7,244.36 Typical High $11,748.98 | Facility | None | $4,466.84 | $7,244.36 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,884.03 Typical High $2,951.21 | Professional | None | $2,691.53 | $2,884.03 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $5,011.87 Typical High $8,709.64 | Facility | None | $1,995.26 | $5,011.87 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,090.30 Typical High $5,888.44 | Professional | None | $2,691.53 | $3,090.30 | $5,888.44 |
Emblem Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $3,801.89 | Professional | None | $2,951.21 | $3,801.89 | $3,801.89 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,365.16 Median $7,943.28 Typical High $22,387.21 | Facility | None | $4,365.16 | $7,943.28 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $4,570.88 | Professional | None | $2,630.27 | $3,162.28 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,073.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $3,890.45 | Professional | None | $1,778.28 | $2,344.23 | $3,890.45 |
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 $1,348.96 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,348.96 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $537.03 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,995.26 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $407.38 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $269.15 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,041.74 | $2,041.74 |
Where New Jersey sits
The same service costs 20.9 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
$2,884
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.