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 $4,466.84 Median $7,244.36 Typical High $11,748.98 | Facility | None | $4,466.84 | $7,244.36 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,122.02 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $6,760.83 | Facility | None | $1,318.26 | $3,890.45 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $3,019.95 | Professional | None | $812.83 | $1,230.27 | $3,019.95 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,698.24 | $1,698.24 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,511.38 Typical High $23,988.33 | Facility | None | $4,677.35 | $8,511.38 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $3,388.44 | Professional | None | $1,071.52 | $1,288.25 | $3,388.44 |
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 $794.33 Median $1,047.13 Typical High $2,511.89 | Professional | None | $794.33 | $1,047.13 | $2,511.89 |
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 $512.86 Median $512.86 Typical High $741.31 | Professional | 52 · Reduced service | $512.86 | $512.86 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $295.12 | Professional | 53 · Discontinued | $204.17 | $204.17 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $776.25 | $776.25 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $218.78 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $147.91 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $1,023.29 |
Where New Jersey sits
The same service costs 6.8 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· 36th of 51
$1,479
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.