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 $1,584.89 Median $1,584.89 Typical High $1,621.81 | Professional | None | $1,584.89 | $1,584.89 | $1,621.81 |
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 $1,479.11 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,479.11 | $1,698.24 | $3,235.94 |
Emblem Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,659.59 | $2,238.72 | $2,238.72 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,454.71 Median $4,570.88 Typical High $12,302.69 | Facility | None | $2,454.71 | $4,570.88 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,621.81 | $1,778.28 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,318.26 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,348.96 | $2,187.76 |
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 $794.33 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
Where New Jersey sits
The same service costs 16.2 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
$1,622
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.