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 $4,365.16 Median $7,943.28 Typical High $12,022.64 | Facility | None | $4,365.16 | $7,943.28 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,288.25 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $3,715.35 Typical High $6,760.83 | Facility | None | $1,995.26 | $3,715.35 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $3,388.44 | Professional | None | $1,023.29 | $1,584.89 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,445.44 | $2,137.96 | $2,137.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $8,511.38 Typical High $22,387.21 | Facility | None | $4,466.84 | $8,511.38 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $3,981.07 | Professional | None | $1,380.38 | $1,659.59 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,073.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $3,235.94 | Professional | None | $1,000.00 | $1,348.96 | $3,235.94 |
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 $645.65 Median $645.65 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $645.65 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,202.26 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $239.88 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,122.02 |
Where New Jersey sits
The same service costs 7.1 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· 40th 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.