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 $1,122.02 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,122.02 | $1,122.02 | $1,202.26 |
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 $1,047.13 Median $1,288.25 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,288.25 | $2,398.83 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,659.59 | $1,659.59 |
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 $1,202.26 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,318.26 | $1,862.09 |
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 $776.25 Median $1,023.29 Typical High $1,584.89 | Professional | None | $776.25 | $1,023.29 | $1,584.89 |
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 $562.34 Median $562.34 Typical High $602.56 | Professional | 52 · Reduced service | $562.34 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $239.88 | Professional | 53 · Discontinued | $223.87 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $912.01 | Professional | 54 · Surgery only | $831.76 | $831.76 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $181.97 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $120.23 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $851.14 |
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
$1,202
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.