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 $1,548.82 Median $8,128.31 Typical High $14,125.38 | Facility | None | $1,548.82 | $8,128.31 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $3,090.30 | Professional | None | $1,258.93 | $1,548.82 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $4,786.30 Typical High $6,918.31 | Facility | None | $2,511.89 | $4,786.30 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $3,715.35 | Professional | None | $1,122.02 | $1,584.89 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,584.89 | $2,344.23 | $2,344.23 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,511.38 Typical High $22,387.21 | Facility | None | $4,677.35 | $8,511.38 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $4,365.16 | Professional | None | $1,513.56 | $1,819.70 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $3,548.13 | Professional | None | $1,096.48 | $1,445.44 | $3,548.13 |
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 $630.96 Median $630.96 Typical High $870.96 | Professional | 52 · Reduced service | $630.96 | $630.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | 53 · Discontinued | $251.19 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $257.04 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,202.26 |
Where New Jersey sits
The same service costs 6.3 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
$1,820
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.