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 $3,801.89 Median $7,943.28 Typical High $12,022.64 | Facility | None | $3,801.89 | $7,943.28 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $870.96 | Professional | None | $645.65 | $831.76 | $870.96 |
AmeriHealth Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $3,981.07 Typical High $6,760.83 | Facility | None | $1,513.56 | $3,981.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,412.54 | Professional | None | $630.96 | $812.83 | $1,412.54 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,318.26 | Professional | None | $954.99 | $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 $588.84 Median $933.25 Typical High $1,621.81 | Professional | None | $588.84 | $933.25 | $1,621.81 |
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 $446.68 Median $616.60 Typical High $1,047.13 | Professional | None | $446.68 | $616.60 | $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 $323.59 Median $371.54 Typical High $436.52 | Professional | 52 · Reduced service | $323.59 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $147.91 Typical High $173.78 | Professional | 53 · Discontinued | $131.83 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $549.54 Typical High $660.69 | Professional | 54 · Surgery only | $489.78 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $112.20 Typical High $131.83 | Professional | 55 · Aftercare only | $97.72 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $74.13 Typical High $87.10 | Professional | 56 · Pre-op care only | $64.57 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $524.81 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $457.09 | $524.81 | $616.60 |
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· 42nd 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.