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 $1,737.80 Median $6,309.57 Typical High $10,471.29 | Facility | None | $1,737.80 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $5,011.87 Typical High $8,511.38 | Facility | None | $1,995.26 | $5,011.87 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $3,548.13 | Professional | None | $1,621.81 | $1,819.70 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,778.28 | $2,398.83 | $2,398.83 |
Horizon BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $10,471.29 Typical High $27,542.29 | Facility | None | $5,888.44 | $10,471.29 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,737.80 | $1,905.46 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,479.11 | $2,344.23 |
4 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 54 · Surgery only Typical Low $1,230.27 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,230.27 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $245.47 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $165.96 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,230.27 | $1,230.27 |
Where New Jersey sits
The same service costs 7.8 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· 39th of 51
$1,738
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.