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 $5,888.44 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $398.11 | Professional | None | $245.47 | $338.84 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,238.72 Typical High $3,630.78 | Facility | None | $933.25 | $2,238.72 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $602.56 | Professional | None | $234.42 | $354.81 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $588.84 | Professional | None | $426.58 | $588.84 | $588.84 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,786.30 Typical High $12,302.69 | Facility | None | $2,630.27 | $4,786.30 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $229.09 Median $436.52 Typical High $724.44 | Professional | None | $229.09 | $436.52 | $724.44 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $457.09 | Professional | None | $181.97 | $275.42 | $457.09 |
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 $123.03 Median $165.96 Typical High $199.53 | Professional | 52 · Reduced service | $123.03 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $66.07 Typical High $79.43 | Professional | 53 · Discontinued | $48.98 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $245.47 Typical High $295.12 | Professional | 54 · Surgery only | $181.97 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $48.98 Typical High $58.88 | Professional | 55 · Aftercare only | $36.31 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $33.11 Typical High $39.81 | Professional | 56 · Pre-op care only | $24.55 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $229.09 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $169.82 | $229.09 | $275.42 |
Where New Jersey sits
The same service costs 5.5 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· 43rd of 51
$331
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.