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 $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,412.54 | Professional | None | $1,348.96 | $1,348.96 | $1,412.54 |
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 $1,318.26 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,548.82 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,995.26 | $1,995.26 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $8,709.64 Typical High $23,988.33 | Facility | None | $4,466.84 | $8,709.64 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,548.82 | $2,137.96 |
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 $954.99 Median $1,202.26 Typical High $1,905.46 | Professional | None | $954.99 | $1,202.26 | $1,905.46 |
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 $676.08 Median $676.08 Typical High $707.95 | Professional | 52 · Reduced service | $676.08 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | 53 · Discontinued | $269.15 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $141.25 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,000.00 |
Where New Jersey sits
The same service costs 17.0 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
$1,349
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.