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 $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | None | $933.25 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $7,762.47 Typical High $15,135.61 | Facility | None | $1,174.90 | $7,762.47 | $15,135.61 |
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 $1,023.29 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,023.29 | $1,348.96 | $1,348.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $21,379.62 Typical High $47,863.01 | Facility | None | $12,022.64 | $21,379.62 | $47,863.01 |
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 $1,548.82 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 $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 $467.74 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $467.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $186.21 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $707.95 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $707.95 |
Where New Jersey sits
The same service costs 7.9 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· 41st of 51
$1,000
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.