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 $549.54 Median $660.69 Typical High $660.69 | Professional | None | $549.54 | $660.69 | $660.69 |
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 $524.81 Median $588.84 Typical High $1,202.26 | Professional | None | $524.81 | $588.84 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $794.33 | Professional | None | $630.96 | $794.33 | $794.33 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,677.35 Typical High $13,182.57 | Facility | None | $2,511.89 | $4,677.35 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $1,000.00 | Professional | None | $562.34 | $602.56 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,220.18 | Facility | None | $1,621.81 | $4,897.79 | $11,220.18 |
United Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $891.25 | Professional | None | $380.19 | $489.78 | $891.25 |
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 $275.42 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $407.38 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $380.19 | $457.09 | $457.09 |
Where New Jersey sits
The same service costs 6.6 times more in Alaska than in Utah. 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· 43rd of 51
$589
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.