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 $2,754.23 Median $5,888.44 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $794.33 | Professional | None | $575.44 | $660.69 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $2,187.76 | Facility | None | $645.65 | $1,202.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,348.96 | Professional | None | $588.84 | $758.58 | $1,348.96 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,174.90 | Professional | None | $891.25 | $1,174.90 | $1,174.90 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,096.48 Median $1,949.84 Typical High $5,888.44 | Facility | None | $1,096.48 | $1,949.84 | $5,888.44 |
Horizon BCBS Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,513.56 | Professional | None | $575.44 | $812.83 | $1,513.56 |
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 $436.52 Median $575.44 Typical High $954.99 | Professional | None | $436.52 | $575.44 | $954.99 |
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 $288.40 Median $323.59 Typical High $389.05 | Professional | 52 · Reduced service | $288.40 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $128.82 Typical High $158.49 | Professional | 53 · Discontinued | $114.82 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $489.78 Typical High $588.84 | Professional | 54 · Surgery only | $426.58 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $117.49 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $64.57 Typical High $79.43 | Professional | 56 · Pre-op care only | $57.54 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $549.54 |
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· 36th of 51
$676
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.