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 $4,365.16 Median $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,621.81 | $1,621.81 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $12,022.64 Typical High $21,379.62 | Facility | None | $1,995.26 | $12,022.64 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,513.56 | $1,778.28 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,737.80 | $2,344.23 | $2,344.23 |
Horizon BCBS Setting Facility Modifier None Typical Low $13,182.57 Median $24,547.09 Typical High $66,069.34 | Facility | None | $13,182.57 | $24,547.09 | $66,069.34 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,698.24 | $1,862.09 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,495.41 Typical High $13,803.84 | Facility | None | $1,659.59 | $5,495.41 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,412.54 | $2,290.87 |
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 $812.83 Median $812.83 Typical High $831.76 | Professional | 52 · Reduced service | $812.83 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $331.13 | Professional | 53 · Discontinued | $323.59 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $251.19 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,174.90 |
Where New Jersey sits
The same service costs 20.4 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
$1,698
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.