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 $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 $977.24 Median $1,122.02 Typical High $2,187.76 | Professional | None | $977.24 | $1,122.02 | $2,187.76 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,479.11 | $1,479.11 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $10,471.29 Typical High $27,542.29 | Facility | None | $5,754.40 | $10,471.29 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,698.24 | Professional | None | $1,071.52 | $1,148.15 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,445.44 | Professional | None | $707.95 | $912.01 | $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 $501.19 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $501.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $758.58 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $776.25 |
Where New Jersey sits
The same service costs 8.3 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
$1,096
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.