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 $912.01 Median $1,047.13 Typical High $1,047.13 | Professional | None | $912.01 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $3,801.89 | Facility | None | $1,318.26 | $2,630.27 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $2,089.30 | Professional | None | $954.99 | $1,071.52 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,412.54 | $1,412.54 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,677.35 Typical High $13,182.57 | Facility | None | $2,511.89 | $4,677.35 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,096.48 | $1,659.59 |
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 $660.69 Median $870.96 Typical High $1,380.38 | Professional | None | $660.69 | $870.96 | $1,380.38 |
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 $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $457.09 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $181.97 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $691.83 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $91.20 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $645.65 | $741.31 | $741.31 |
Where New Jersey sits
The same service costs 16.2 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
$1,047
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.