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 $9,332.54 Typical High $14,125.38 | Facility | None | $4,466.84 | $9,332.54 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $758.58 | Professional | None | $724.44 | $724.44 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $4,265.80 Typical High $6,760.83 | Facility | None | $1,548.82 | $4,265.80 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,548.82 | Professional | None | $707.95 | $831.76 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,071.52 | Professional | None | $794.33 | $1,071.52 | $1,071.52 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $8,511.38 Typical High $23,988.33 | Facility | None | $4,466.84 | $8,511.38 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,202.26 | Professional | None | $707.95 | $851.14 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,918.31 | Facility | None | $1,122.02 | $2,884.03 | $6,918.31 |
United Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $1,047.13 | Professional | None | $512.86 | $645.65 | $1,047.13 |
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 $363.08 Median $363.08 Typical High $380.19 | Professional | 52 · Reduced service | $363.08 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | 53 · Discontinued | $144.54 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $562.34 | Professional | 54 · Surgery only | $537.03 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $114.82 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $524.81 |
Where New Jersey sits
The same service costs 8.5 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· 45th of 51
$741
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.