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 $1,698.24 Median $6,309.57 Typical High $10,964.78 | Facility | None | $1,698.24 | $6,309.57 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,698.24 | $1,698.24 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $4,570.88 Typical High $8,128.31 | Facility | None | $1,995.26 | $4,570.88 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,584.89 | $1,819.70 | $3,467.37 |
Emblem Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,862.09 | $2,398.83 | $2,398.83 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $7,585.78 Typical High $27,542.29 | Facility | None | $4,073.80 | $7,585.78 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,737.80 | $1,862.09 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,445.44 | $2,344.23 |
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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
Where New Jersey sits
The same service costs 7.8 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· 39th of 51
$1,738
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.