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 $4,265.80 Median $6,606.93 Typical High $11,481.54 | Facility | None | $4,265.80 | $6,606.93 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $794.33 | Professional | None | $588.84 | $741.31 | $794.33 |
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 $645.65 Median $776.25 Typical High $1,479.11 | Professional | None | $645.65 | $776.25 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | None | $776.25 | $1,047.13 | $1,047.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $13,182.57 | Facility | None | $2,630.27 | $4,677.35 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,202.26 | Professional | None | $707.95 | $831.76 | $1,202.26 |
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 $501.19 Median $630.96 Typical High $954.99 | Professional | None | $501.19 | $630.96 | $954.99 |
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 $295.12 Median $371.54 Typical High $398.11 | Professional | 52 · Reduced service | $295.12 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $147.91 Typical High $158.49 | Professional | 53 · Discontinued | $117.49 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $562.34 Typical High $588.84 | Professional | 54 · Surgery only | $446.68 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $112.20 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $74.13 Typical High $79.43 | Professional | 56 · Pre-op care only | $58.88 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $524.81 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $416.87 | $524.81 | $549.54 |
Where New Jersey sits
The same service costs 6.6 times more in Alaska than in Utah. 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
$741
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.