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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $575.44 | Professional | None | $537.03 | $537.03 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,818.38 Typical High $5,128.61 | Facility | None | $933.25 | $2,818.38 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,202.26 | Professional | None | $537.03 | $630.96 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $870.96 | Professional | None | $645.65 | $870.96 | $870.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,786.30 Typical High $12,302.69 | Facility | None | $2,630.27 | $4,786.30 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $977.24 | Professional | None | $588.84 | $645.65 | $977.24 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $794.33 | Professional | None | $407.38 | $512.86 | $794.33 |
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 $269.15 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $269.15 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $107.15 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $407.38 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $407.38 |
Where New Jersey sits
The same service costs 7.9 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
$589
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.