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 $1,071.52 Median $1,071.52 Typical High $1,096.48 | Professional | None | $1,071.52 | $1,071.52 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $11,481.54 Typical High $20,892.96 | Facility | None | $1,995.26 | $11,481.54 | $20,892.96 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,202.26 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $416.87 Median $831.76 Typical High $1,148.15 | Professional | None | $416.87 | $831.76 | $1,148.15 |
Horizon BCBS Setting Facility Modifier None Typical Low $10,715.19 Median $19,054.61 Typical High $47,863.01 | Facility | None | $10,715.19 | $19,054.61 | $47,863.01 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,230.27 | $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 $812.83 Median $954.99 Typical High $1,548.82 | Professional | None | $812.83 | $954.99 | $1,548.82 |
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 $537.03 Median $537.03 Typical High $549.54 | Professional | 52 · Reduced service | $537.03 | $537.03 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $218.78 | Professional | 53 · Discontinued | $213.80 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $812.83 | Professional | 54 · Surgery only | $794.33 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $162.18 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $109.65 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $758.58 |
Where New Jersey sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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· 46th of 51
$1,122
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.