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 $1,258.93 Median $1,258.93 Typical High $1,288.25 | Professional | None | $1,258.93 | $1,258.93 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $10,964.78 Typical High $21,379.62 | Facility | None | $1,318.26 | $10,964.78 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,412.54 | $2,630.27 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,479.11 | $1,862.09 | $1,862.09 |
Horizon BCBS Setting Facility Modifier None Typical Low $10,000.00 Median $18,197.01 Typical High $47,863.01 | Facility | None | $10,000.00 | $18,197.01 | $47,863.01 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,445.44 | $2,137.96 |
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 $891.25 Median $1,122.02 Typical High $1,778.28 | Professional | None | $891.25 | $1,122.02 | $1,778.28 |
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 $630.96 Median $630.96 Typical High $645.65 | Professional | 52 · Reduced service | $630.96 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $257.04 | Professional | 53 · Discontinued | $251.19 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $977.24 | Professional | 54 · Surgery only | $954.99 | $954.99 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $128.82 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $912.01 |
Where New Jersey sits
The same service costs 7.6 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· 42nd of 51
$1,318
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.