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 $8,912.51 Typical High $13,803.84 | Facility | None | $4,466.84 | $8,912.51 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,905.46 | $1,905.46 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $12,302.69 Typical High $21,877.62 | Facility | None | $1,995.26 | $12,302.69 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $4,168.69 | Professional | None | $1,819.70 | $2,137.96 | $4,168.69 |
Emblem Health Setting Professional Modifier None Typical Low $2,344.23 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,344.23 | $3,090.30 | $3,090.30 |
Horizon BCBS Setting Facility Modifier None Typical Low $8,511.38 Median $15,135.61 Typical High $47,863.01 | Facility | None | $8,511.38 | $15,135.61 | $47,863.01 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $3,311.31 | Professional | None | $2,041.74 | $2,187.76 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,495.41 Typical High $13,803.84 | Facility | None | $1,659.59 | $5,495.41 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,479.11 | $1,737.80 | $2,884.03 |
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 $954.99 Median $954.99 Typical High $1,023.29 | Professional | 52 · Reduced service | $954.99 | $954.99 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $416.87 | Professional | 53 · Discontinued | $380.19 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $309.03 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $204.17 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,445.44 |
Where New Jersey sits
The same service costs 16.2 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
$2,042
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.