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 $707.95 Median $6,309.57 Typical High $10,471.29 | Facility | None | $707.95 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $724.44 | Professional | None | $707.95 | $707.95 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,570.40 Typical High $3,801.89 | Facility | None | $1,174.90 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,513.56 | Professional | None | $676.08 | $794.33 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,071.52 | Professional | None | $794.33 | $1,071.52 | $1,071.52 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $12,302.69 | Facility | None | $2,630.27 | $4,677.35 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,230.27 | Professional | None | $758.58 | $812.83 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
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 $354.81 Median $354.81 Typical High $363.08 | Professional | 52 · Reduced service | $354.81 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $549.54 | Professional | 54 · Surgery only | $537.03 | $537.03 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $109.65 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $72.44 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $512.86 |
Where New Jersey sits
The same service costs 8.5 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.