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 $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $616.60 | Professional | None | $562.34 | $562.34 | $616.60 |
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 $457.09 Median $537.03 Typical High $1,096.48 | Professional | None | $457.09 | $537.03 | $1,096.48 |
Emblem Health Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $724.44 | Professional | None | $537.03 | $724.44 | $724.44 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $7,585.78 Typical High $22,387.21 | Facility | None | $4,168.69 | $7,585.78 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $870.96 | Professional | None | $501.19 | $588.84 | $870.96 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,918.31 | Facility | None | $1,122.02 | $2,884.03 | $6,918.31 |
United Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $724.44 | Professional | None | $338.84 | $446.68 | $724.44 |
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 $281.84 Median $281.84 Typical High $309.03 | Professional | 52 · Reduced service | $281.84 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $123.03 | Professional | 53 · Discontinued | $112.20 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $416.87 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $61.66 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $426.58 |
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· 41st of 51
$537
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.