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 $758.58 Median $7,762.47 Typical High $12,022.64 | Facility | None | $758.58 | $7,762.47 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | None | $741.31 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $3,630.78 Typical High $6,760.83 | Facility | None | $1,698.24 | $3,630.78 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,621.81 | Professional | None | $724.44 | $851.14 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | None | $831.76 | $1,122.02 | $1,122.02 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,511.38 Typical High $23,988.33 | Facility | None | $4,677.35 | $8,511.38 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,258.93 | Professional | None | $758.58 | $891.25 | $1,258.93 |
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 $537.03 Median $676.08 Typical High $1,096.48 | Professional | None | $537.03 | $676.08 | $1,096.48 |
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 $371.54 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $371.54 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $147.91 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 54 · Surgery only | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $114.82 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $537.03 |
Where New Jersey sits
The same service costs 16.6 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
$759
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.