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 $1,479.11 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,479.11 | $1,479.11 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $4,570.88 Typical High $8,128.31 | Facility | None | $1,995.26 | $4,570.88 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $3,467.37 | Professional | None | $1,659.59 | $1,949.84 | $3,467.37 |
Emblem Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,137.96 | $2,818.38 | $2,818.38 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $9,772.37 Typical High $27,542.29 | Facility | None | $5,370.32 | $9,772.37 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,819.70 | $1,949.84 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,548.82 | $2,511.89 |
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 $741.31 Median $741.31 Typical High $812.83 | Professional | 52 · Reduced service | $741.31 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $323.59 | Professional | 53 · Discontinued | $295.12 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $162.18 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,122.02 |
Where New Jersey sits
The same service costs 11.2 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· 40th of 51
$1,820
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.