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 $4,365.16 Median $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,071.52 | Professional | None | $831.76 | $831.76 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,570.40 Typical High $3,801.89 | Facility | None | $1,174.90 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $2,041.74 | Professional | None | $891.25 | $1,071.52 | $2,041.74 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,071.52 | $1,412.54 | $1,412.54 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $4,265.80 Typical High $12,302.69 | Facility | None | $2,344.23 | $4,265.80 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,148.15 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,348.96 | Professional | None | $676.08 | $851.14 | $1,348.96 |
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 $416.87 Median $416.87 Typical High $537.03 | Professional | 52 · Reduced service | $416.87 | $416.87 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $213.80 | Professional | 53 · Discontinued | $165.96 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $794.33 | Professional | 54 · Surgery only | $630.96 | $630.96 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $158.49 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $107.15 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $741.31 |
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· 38th of 51
$1,072
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.