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 $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,174.90 | Professional | None | $1,096.48 | $1,096.48 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $8,912.51 Typical High $15,488.17 | Facility | None | $1,995.26 | $8,912.51 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,230.27 | $2,344.23 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,659.59 | $1,659.59 |
Horizon BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $18,620.87 Typical High $47,863.01 | Facility | None | $10,000.00 | $18,620.87 | $47,863.01 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,288.25 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,786.30 | $11,481.54 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,584.89 | Professional | None | $776.25 | $1,000.00 | $1,584.89 |
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 $549.54 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $234.42 | Professional | 53 · Discontinued | $218.78 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $870.96 | Professional | 54 · Surgery only | $831.76 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $117.49 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $812.83 |
Where New Jersey sits
The same service costs 8.3 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
$1,175
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.