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 $812.83 Median $812.83 Typical High $851.14 | Professional | None | $812.83 | $812.83 | $851.14 |
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 $794.33 Median $933.25 Typical High $1,778.28 | Professional | None | $794.33 | $933.25 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | None | $933.25 | $1,258.93 | $1,258.93 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $5,888.44 Typical High $27,542.29 | Facility | None | $3,235.94 | $5,888.44 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,412.54 | Professional | None | $870.96 | $954.99 | $1,412.54 |
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 $588.84 Median $741.31 Typical High $1,174.90 | Professional | None | $588.84 | $741.31 | $1,174.90 |
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 $407.38 Median $407.38 Typical High $426.58 | Professional | 52 · Reduced service | $407.38 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $162.18 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $645.65 | Professional | 54 · Surgery only | $602.56 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $602.56 |
Where New Jersey sits
The same service costs 7.6 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· 40th of 51
$871
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.