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 $2,754.23 Median $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $707.95 | Professional | None | $676.08 | $676.08 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $2,187.76 | Facility | None | $691.83 | $1,380.38 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,479.11 | Professional | None | $660.69 | $776.25 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,047.13 | Professional | None | $812.83 | $1,047.13 | $1,047.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $2,511.89 Typical High $6,456.54 | Facility | None | $1,380.38 | $2,511.89 | $6,456.54 |
Horizon BCBS Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,174.90 | Professional | None | $724.44 | $794.33 | $1,174.90 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,479.11 Typical High $3,890.45 | Facility | None | $316.23 | $1,479.11 | $3,890.45 |
United Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $954.99 | Professional | None | $501.19 | $616.60 | $954.99 |
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 $338.84 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 53 · Discontinued | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | 54 · Surgery only | $512.86 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $489.78 |
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
$708
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.