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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,659.59 | Professional | None | $1,513.56 | $1,513.56 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,238.72 Typical High $3,630.78 | Facility | None | $933.25 | $2,238.72 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $3,467.37 | Professional | None | $1,584.89 | $1,862.09 | $3,467.37 |
Emblem Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,819.70 | $2,454.71 | $2,454.71 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,365.16 Typical High $12,302.69 | Facility | None | $2,511.89 | $4,365.16 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,737.80 | $1,905.46 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,174.90 | $1,479.11 | $2,290.87 |
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 $741.31 Median $741.31 Typical High $831.76 | Professional | 52 · Reduced service | $741.31 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | 53 · Discontinued | $302.00 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $165.96 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,174.90 |
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
$1,738
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.