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 $758.58 Median $831.76 Typical High $831.76 | Professional | None | $758.58 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $10,000.00 Typical High $19,054.61 | Facility | None | $1,174.90 | $10,000.00 | $19,054.61 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,621.81 | Professional | None | $741.31 | $831.76 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | None | $831.76 | $1,122.02 | $1,122.02 |
Horizon BCBS Setting Facility Modifier None Typical Low $10,232.93 Median $20,417.38 Typical High $47,863.01 | Facility | None | $10,232.93 | $20,417.38 | $47,863.01 |
Horizon BCBS Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $1,318.26 | Professional | None | $776.25 | $851.14 | $1,318.26 |
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 $524.81 Median $691.83 Typical High $1,096.48 | Professional | None | $524.81 | $691.83 | $1,096.48 |
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 $380.19 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $380.19 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $151.36 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $575.44 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $537.03 | $575.44 | $575.44 |
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· 40th of 51
$832
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.