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 $4,466.84 Median $7,244.36 Typical High $11,748.98 | Facility | None | $4,466.84 | $7,244.36 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $891.25 | Professional | None | $831.76 | $831.76 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,630.27 Typical High $3,801.89 | Facility | None | $1,548.82 | $2,630.27 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,819.70 | Professional | None | $812.83 | $954.99 | $1,819.70 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,023.29 | $1,318.26 | $1,318.26 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,786.30 Typical High $12,302.69 | Facility | None | $2,630.27 | $4,786.30 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,445.44 | Professional | None | $912.01 | $977.24 | $1,445.44 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,754.40 | Facility | None | $707.95 | $1,995.26 | $5,754.40 |
United Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,202.26 | Professional | None | $616.60 | $758.58 | $1,202.26 |
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 $416.87 Median $416.87 Typical High $446.68 | Professional | 52 · Reduced service | $416.87 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $177.83 | Professional | 53 · Discontinued | $165.96 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | 54 · Surgery only | $616.60 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $630.96 |
Where New Jersey sits
The same service costs 7.1 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
$891
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.