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 $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,187.76 Typical High $3,630.78 | Facility | None | $691.83 | $2,187.76 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,412.54 | Professional | None | $676.08 | $794.33 | $1,412.54 |
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 $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 $691.83 Median $758.58 Typical High $1,148.15 | Professional | None | $691.83 | $758.58 | $1,148.15 |
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 $524.81 Median $602.56 Typical High $933.25 | Professional | None | $524.81 | $602.56 | $933.25 |
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 $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $446.68 |
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· 38th of 51
$708
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.