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 $2,754.23 Median $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | None | $407.38 | $407.38 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,187.76 Typical High $3,801.89 | Facility | None | $691.83 | $2,187.76 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $912.01 | Professional | None | $407.38 | $478.63 | $912.01 |
Emblem Health Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $660.69 | Professional | None | $489.78 | $660.69 | $660.69 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $12,302.69 | Facility | None | $2,630.27 | $4,677.35 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $724.44 | Professional | None | $446.68 | $478.63 | $724.44 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $588.84 | Professional | None | $316.23 | $380.19 | $588.84 |
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 $204.17 Median $204.17 Typical High $213.80 | Professional | 52 · Reduced service | $204.17 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 53 · Discontinued | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | 54 · Surgery only | $309.03 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $42.66 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $302.00 |
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
$447
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.