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 $380.19 Median $380.19 Typical High $407.38 | Professional | None | $380.19 | $380.19 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,137.96 Typical High $3,630.78 | Facility | None | $691.83 | $2,137.96 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $870.96 | Professional | None | $398.11 | $467.74 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $645.65 | Professional | None | $478.63 | $645.65 | $645.65 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $12,302.69 | Facility | None | $2,630.27 | $4,677.35 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $691.83 | Professional | None | $426.58 | $467.74 | $691.83 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,584.89 Typical High $4,168.69 | Facility | None | $537.03 | $1,584.89 | $4,168.69 |
United Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $575.44 | Professional | None | $309.03 | $363.08 | $575.44 |
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 $190.55 Median $190.55 Typical High $204.17 | Professional | 52 · Reduced service | $190.55 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $83.18 | Professional | 53 · Discontinued | $75.86 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $309.03 | Professional | 54 · Surgery only | $288.40 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $61.66 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $288.40 |
Where New Jersey sits
The same service costs 8.1 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
$427
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.