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 $676.08 Median $6,918.31 Typical High $11,748.98 | Facility | None | $676.08 | $6,918.31 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | None | $676.08 | $676.08 | $691.83 |
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 $630.96 Median $741.31 Typical High $1,412.54 | Professional | None | $630.96 | $741.31 | $1,412.54 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,000.00 | Professional | None | $741.31 | $1,000.00 | $1,000.00 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $10,471.29 Typical High $27,542.29 | Facility | None | $5,754.40 | $10,471.29 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,122.02 | Professional | None | $691.83 | $758.58 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $933.25 | Professional | None | $478.63 | $588.84 | $933.25 |
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 $331.13 Median $331.13 Typical High $338.84 | Professional | 52 · Reduced service | $331.13 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $138.04 | Professional | 53 · Discontinued | $134.90 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $512.86 | Professional | 54 · Surgery only | $501.19 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $102.33 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $478.63 |
Where New Jersey sits
The same service costs 8.1 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
$692
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.