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 $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $6,760.83 Typical High $10,471.29 | Facility | None | $3,388.44 | $6,760.83 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,905.46 | Professional | None | $851.14 | $1,000.00 | $1,905.46 |
Emblem Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,318.26 | $1,318.26 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $7,244.36 Typical High $27,542.29 | Facility | None | $4,073.80 | $7,244.36 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,548.82 | Professional | None | $933.25 | $1,023.29 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,786.30 | $11,481.54 |
United Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,258.93 | Professional | None | $630.96 | $794.33 | $1,258.93 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | 54 · Surgery only | $676.08 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $138.04 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $645.65 |
Where New Jersey sits
The same service costs 13.8 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
$933
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.