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 $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,122.02 | Professional | None | $588.84 | $588.84 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,090.30 Typical High $5,248.07 | Facility | None | $1,174.90 | $3,090.30 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $2,089.30 | Professional | None | $912.01 | $1,174.90 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,584.89 | $1,584.89 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $12,302.69 | Facility | None | $2,630.27 | $4,677.35 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,230.27 | $1,584.89 |
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 $741.31 Median $912.01 Typical High $1,445.44 | Professional | None | $741.31 | $912.01 | $1,445.44 |
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 $295.12 Median $295.12 Typical High $562.34 | Professional | 52 · Reduced service | $295.12 | $295.12 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $223.87 | Professional | 53 · Discontinued | $117.49 | $117.49 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $851.14 | Professional | 54 · Surgery only | $436.52 | $436.52 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $169.82 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $112.20 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $407.38 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $407.38 | $407.38 | $794.33 |
Where New Jersey sits
The same service costs 7.8 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· 35th of 51
$1,122
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.