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 $1,023.29 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,023.29 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,570.40 Typical High $3,801.89 | Facility | None | $1,174.90 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,122.02 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,513.56 | $1,513.56 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,677.35 Typical High $12,302.69 | Facility | None | $2,511.89 | $4,677.35 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,148.15 | $1,778.28 |
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 $707.95 Median $933.25 Typical High $1,445.44 | Professional | None | $707.95 | $933.25 | $1,445.44 |
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 $512.86 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $512.86 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $208.93 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $776.25 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $102.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $724.44 | $758.58 | $758.58 |
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· 40th of 51
$1,096
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.