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 $4,365.16 Median $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | None | $851.14 | $851.14 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $4,466.84 Typical High $8,128.31 | Facility | None | $1,174.90 | $4,466.84 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,778.28 | Professional | None | $812.83 | $954.99 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $1,288.25 | Professional | None | $954.99 | $1,288.25 | $1,288.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,623.41 Median $10,471.29 Typical High $29,512.09 | Facility | None | $5,623.41 | $10,471.29 | $29,512.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,479.11 | Professional | None | $912.01 | $977.24 | $1,479.11 |
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 $602.56 Median $758.58 Typical High $1,202.26 | Professional | None | $602.56 | $758.58 | $1,202.26 |
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 $426.58 Median $426.58 Typical High $446.68 | Professional | 52 · Reduced service | $426.58 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | 53 · Discontinued | $169.82 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $660.69 | Professional | 54 · Surgery only | $645.65 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $616.60 |
Where New Jersey sits
The same service costs 8.1 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· 39th of 51
$912
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.