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 $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $691.83 | Professional | None | $602.56 | $676.08 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $3,630.78 | Facility | None | $1,659.59 | $2,570.40 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,412.54 | Professional | None | $630.96 | $741.31 | $1,412.54 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,000.00 | Professional | None | $741.31 | $1,000.00 | $1,000.00 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $8,709.64 Typical High $13,182.57 | Facility | None | $5,370.32 | $8,709.64 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,122.02 | Professional | None | $707.95 | $758.58 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,220.18 | Facility | None | $1,621.81 | $4,786.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $933.25 | Professional | None | $467.74 | $588.84 | $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 $302.00 Median $338.84 Typical High $346.74 | Professional | 52 · Reduced service | $302.00 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $134.90 Typical High $138.04 | Professional | 53 · Discontinued | $120.23 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $457.09 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $67.61 Typical High $69.18 | Professional | 56 · Pre-op care only | $60.26 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $426.58 | $478.63 | $478.63 |
Where New Jersey sits
The same service costs 16.6 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
$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.