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 $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $5,370.32 Typical High $10,471.29 | Facility | None | $1,513.56 | $5,370.32 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,995.26 | Professional | None | $912.01 | $1,047.13 | $1,995.26 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,380.38 | $1,380.38 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,317.64 Typical High $27,542.29 | Facility | None | $4,786.30 | $8,317.64 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,071.52 | $1,548.82 |
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 $660.69 Median $831.76 Typical High $1,348.96 | Professional | None | $660.69 | $831.76 | $1,348.96 |
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 $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $724.44 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $691.83 |
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
$1,000
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.