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 $912.01 Median $977.24 Typical High $977.24 | Professional | None | $912.01 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,174.90 | $4,265.80 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,995.26 | Professional | None | $912.01 | $1,023.29 | $1,995.26 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $870.96 | $1,348.96 | $1,348.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,623.41 Median $10,471.29 Typical High $27,542.29 | Facility | None | $5,623.41 | $10,471.29 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,621.81 | Professional | None | $954.99 | $1,047.13 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,318.26 | Professional | None | $645.65 | $831.76 | $1,318.26 |
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 $457.09 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $457.09 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $181.97 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $676.08 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $691.83 |
Where New Jersey sits
The same service costs 14.5 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
$977
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.