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 $9,120.11 Typical High $14,125.38 | Facility | None | $4,365.16 | $9,120.11 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $812.83 | Professional | None | $645.65 | $741.31 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,380.38 Typical High $4,466.84 | Facility | None | $794.33 | $1,380.38 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,412.54 | Professional | None | $645.65 | $831.76 | $1,412.54 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,288.25 | Professional | None | $954.99 | $1,288.25 | $1,288.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $5,888.44 | Facility | None | $1,047.13 | $1,862.09 | $5,888.44 |
Horizon BCBS Setting Professional Modifier None Typical Low $602.56 Median $912.01 Typical High $1,659.59 | Professional | None | $602.56 | $912.01 | $1,659.59 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,023.29 | Professional | None | $467.74 | $616.60 | $1,023.29 |
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 $363.08 Typical High $407.38 | Professional | 52 · Reduced service | $323.59 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $144.54 Typical High $162.18 | Professional | 53 · Discontinued | $128.82 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $489.78 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $81.28 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $575.44 |
Where New Jersey sits
The same service costs 5.6 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
$724
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.