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 $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $758.58 | Professional | None | $645.65 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $4,786.30 Typical High $8,511.38 | Facility | None | $1,995.26 | $4,786.30 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $1,548.82 | Professional | None | $691.83 | $794.33 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,047.13 | Professional | None | $794.33 | $1,047.13 | $1,047.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $10,232.93 Median $17,378.01 Typical High $30,902.95 | Facility | None | $10,232.93 | $17,378.01 | $30,902.95 |
Horizon BCBS Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,258.93 | Professional | None | $741.31 | $794.33 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,786.30 | $11,481.54 |
United Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,000.00 | Professional | None | $501.19 | $645.65 | $1,000.00 |
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 $323.59 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $524.81 | $524.81 |
Where New Jersey sits
The same service costs 8.7 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
$759
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.