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 $741.31 Median $741.31 Typical High $1,412.54 | Professional | None | $741.31 | $741.31 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $5,888.44 Typical High $10,964.78 | Facility | None | $1,698.24 | $5,888.44 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,479.11 | $2,630.27 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,949.84 | $1,949.84 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $10,471.29 Typical High $29,512.09 | Facility | None | $5,754.40 | $10,471.29 | $29,512.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,548.82 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,819.70 | Professional | None | $912.01 | $1,148.15 | $1,819.70 |
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 $371.54 Median $371.54 Typical High $707.95 | Professional | 52 · Reduced service | $371.54 | $371.54 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $281.84 | Professional | 53 · Discontinued | $151.36 | $151.36 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $1,071.52 | Professional | 54 · Surgery only | $562.34 | $562.34 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $213.80 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $141.25 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $1,000.00 |
Where New Jersey sits
The same service costs 8.9 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· 35th of 51
$1,413
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.