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 $7,244.36 Typical High $11,748.98 | Facility | None | $4,466.84 | $7,244.36 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,071.52 | Professional | None | $1,047.13 | $1,047.13 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $4,466.84 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,466.84 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $2,187.76 | Professional | None | $977.24 | $1,148.15 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,513.56 | $1,513.56 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $5,888.44 Typical High $27,542.29 | Facility | None | $3,162.28 | $5,888.44 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,174.90 | $1,698.24 |
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 $707.95 Median $912.01 Typical High $1,445.44 | Professional | None | $707.95 | $912.01 | $1,445.44 |
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 $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $213.80 | Professional | 53 · Discontinued | $208.93 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $107.15 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $741.31 |
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
$1,072
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.