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 $741.31 Median $6,309.57 Typical High $10,471.29 | Facility | None | $741.31 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $776.25 | Professional | None | $741.31 | $741.31 | $776.25 |
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 $691.83 Median $831.76 Typical High $1,548.82 | Professional | None | $691.83 | $831.76 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,096.48 | Professional | None | $831.76 | $1,096.48 | $1,096.48 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $10,471.29 Typical High $29,512.09 | Facility | None | $5,754.40 | $10,471.29 | $29,512.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,258.93 | Professional | None | $776.25 | $831.76 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,918.31 | Facility | None | $1,122.02 | $2,884.03 | $6,918.31 |
United Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,023.29 | Professional | None | $524.81 | $660.69 | $1,023.29 |
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 $371.54 Median $371.54 Typical High $380.19 | Professional | 52 · Reduced service | $371.54 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | 53 · Discontinued | $147.91 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $524.81 |
Where New Jersey sits
The same service costs 7.6 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· 43rd of 51
$776
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.