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 $630.96 Median $676.08 Typical High $676.08 | Professional | None | $630.96 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $3,630.78 | Facility | None | $1,659.59 | $2,570.40 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,479.11 | Professional | None | $691.83 | $812.83 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,096.48 | Professional | None | $812.83 | $1,096.48 | $1,096.48 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $8,912.51 Typical High $13,803.84 | Facility | None | $5,128.61 | $8,912.51 | $13,803.84 |
Horizon BCBS Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,202.26 | Professional | None | $741.31 | $794.33 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,220.18 | Facility | None | $1,621.81 | $4,786.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $977.24 | Professional | None | $524.81 | $630.96 | $977.24 |
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 $316.23 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $316.23 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $125.89 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $467.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $63.10 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $478.63 |
Where New Jersey sits
The same service costs 19.5 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· 42nd of 51
$741
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.