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 $2,754.23 Median $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $489.78 | Professional | None | $467.74 | $467.74 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $2,187.76 | Facility | None | $691.83 | $1,380.38 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $1,071.52 | Professional | None | $478.63 | $562.34 | $1,071.52 |
Emblem Health Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $776.25 | Professional | None | $575.44 | $776.25 | $776.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $2,511.89 Typical High $6,025.60 | Facility | None | $1,380.38 | $2,511.89 | $6,025.60 |
Horizon BCBS Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $831.76 | Professional | None | $512.86 | $562.34 | $831.76 |
United Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $5,623.41 | Facility | None | $724.44 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $691.83 | Professional | None | $371.54 | $436.52 | $691.83 |
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 $234.42 Median $234.42 Typical High $245.47 | Professional | 52 · Reduced service | $234.42 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $100.00 | Professional | 53 · Discontinued | $93.33 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $371.54 | Professional | 54 · Surgery only | $346.74 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $74.13 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $48.98 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $346.74 |
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
$513
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.