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 $707.95 Typical High $707.95 | Professional | None | $602.56 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,949.84 | $2,818.38 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,445.44 | Professional | None | $676.08 | $812.83 | $1,445.44 |
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 $4,786.30 Median $8,912.51 Typical High $13,803.84 | Facility | None | $4,786.30 | $8,912.51 | $13,803.84 |
Horizon BCBS Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,202.26 | Professional | None | $758.58 | $812.83 | $1,202.26 |
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 $512.86 Median $645.65 Typical High $1,000.00 | Professional | None | $512.86 | $645.65 | $1,000.00 |
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 $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $302.00 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $120.23 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $446.68 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $60.26 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $416.87 | $501.19 | $501.19 |
Where New Jersey sits
The same service costs 7.6 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· 40th of 51
$759
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.