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 $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,230.27 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $6,025.60 Typical High $10,715.19 | Facility | None | $1,995.26 | $6,025.60 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,318.26 | $2,570.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,698.24 | $1,698.24 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $9,772.37 Typical High $27,542.29 | Facility | None | $5,128.61 | $9,772.37 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $1,995.26 | Professional | None | $1,258.93 | $1,348.96 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,737.80 | Professional | None | $794.33 | $1,047.13 | $1,737.80 |
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 $616.60 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $616.60 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $912.01 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $123.03 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $891.25 |
Where New Jersey sits
The same service costs 8.7 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
$1,259
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.