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 $933.25 Median $1,000.00 Typical High $1,071.52 | Professional | None | $933.25 | $1,000.00 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $3,801.89 | Facility | None | $1,698.24 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $2,137.96 | Professional | None | $977.24 | $1,148.15 | $2,137.96 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,513.56 | $1,513.56 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $8,912.51 Typical High $13,182.57 | Facility | None | $5,128.61 | $8,912.51 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,174.90 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $11,220.18 | Facility | None | $1,621.81 | $4,786.30 | $11,220.18 |
United Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,445.44 | Professional | None | $724.44 | $912.01 | $1,445.44 |
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 $467.74 Median $501.19 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $213.80 | Professional | 53 · Discontinued | $190.55 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $107.15 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $758.58 |
Where New Jersey sits
The same service costs 18.2 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· 41st of 51
$1,096
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.