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 $1,318.26 Median $1,348.96 Typical High $1,380.38 | Professional | None | $1,318.26 | $1,348.96 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,630.27 Typical High $3,801.89 | Facility | None | $1,318.26 | $2,630.27 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,584.89 | $2,884.03 |
Emblem Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,548.82 | $2,089.30 | $2,089.30 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $4,677.35 Typical High $12,302.69 | Facility | None | $2,691.53 | $4,677.35 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,445.44 | $1,548.82 | $2,344.23 |
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 $1,000.00 Median $1,202.26 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,202.26 | $1,905.46 |
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 $660.69 Median $660.69 Typical High $691.83 | Professional | 52 · Reduced service | $660.69 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $269.15 Typical High $275.42 | Professional | 53 · Discontinued | $263.03 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,023.29 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $204.17 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $134.90 Typical High $138.04 | Professional | 56 · Pre-op care only | $131.83 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $954.99 |
Where New Jersey sits
The same service costs 7.9 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· 39th of 51
$1,445
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.