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 $977.24 Median $977.24 Typical High $1,023.29 | Professional | None | $977.24 | $977.24 | $1,023.29 |
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 $954.99 Median $1,122.02 Typical High $2,089.30 | Professional | None | $954.99 | $1,122.02 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,445.44 | $1,445.44 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $8,317.64 Typical High $23,988.33 | Facility | None | $4,466.84 | $8,317.64 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,621.81 | Professional | None | $977.24 | $1,148.15 | $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 $676.08 Median $870.96 Typical High $1,412.54 | Professional | None | $676.08 | $870.96 | $1,412.54 |
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 $489.78 Median $489.78 Typical High $512.86 | Professional | 52 · Reduced service | $489.78 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $204.17 | Professional | 53 · Discontinued | $194.98 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $776.25 | Professional | 54 · Surgery only | $724.44 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $154.88 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $102.33 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $724.44 |
Where New Jersey sits
The same service costs 18.2 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
$1,000
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.