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 $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,380.38 | Professional | None | $977.24 | $977.24 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $3,981.07 Typical High $6,760.83 | Facility | None | $1,513.56 | $3,981.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $2,951.21 | Professional | None | $912.01 | $1,288.25 | $2,951.21 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,905.46 | $1,905.46 |
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 $1,202.26 Median $1,479.11 Typical High $3,467.37 | Professional | None | $1,202.26 | $1,479.11 | $3,467.37 |
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 $891.25 Median $1,174.90 Typical High $2,818.38 | Professional | None | $891.25 | $1,174.90 | $2,818.38 |
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 $489.78 Median $489.78 Typical High $691.83 | Professional | 52 · Reduced service | $489.78 | $489.78 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $275.42 | Professional | 53 · Discontinued | $194.98 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $1,047.13 | Professional | 54 · Surgery only | $741.31 | $741.31 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $208.93 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $138.04 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $977.24 |
Where New Jersey sits
The same service costs 6.6 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· 41st 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.