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 $380.19 Median $6,025.60 Typical High $10,964.78 | Facility | None | $380.19 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $562.34 | Professional | None | $380.19 | $537.03 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,412.54 Typical High $3,311.31 | Facility | None | $794.33 | $1,412.54 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $512.86 Typical High $851.14 | Professional | None | $371.54 | $512.86 | $851.14 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $831.76 | Professional | None | $602.56 | $831.76 | $831.76 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,137.96 Typical High $6,165.95 | Facility | None | $1,174.90 | $2,137.96 | $6,165.95 |
Horizon BCBS Setting Professional Modifier None Typical Low $354.81 Median $616.60 Typical High $1,023.29 | Professional | None | $354.81 | $616.60 | $1,023.29 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $660.69 | Professional | None | $281.84 | $398.11 | $660.69 |
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 $234.42 Typical High $281.84 | Professional | 52 · Reduced service | $190.55 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $93.33 Typical High $112.20 | Professional | 53 · Discontinued | $75.86 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $346.74 Typical High $416.87 | Professional | 54 · Surgery only | $288.40 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $69.18 Typical High $83.18 | Professional | 55 · Aftercare only | $57.54 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $46.77 Typical High $56.23 | Professional | 56 · Pre-op care only | $38.02 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $323.59 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $269.15 | $323.59 | $389.05 |
Where New Jersey sits
The same service costs 4.8 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· 40th of 51
$479
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.