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 $1,258.93 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,258.93 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $3,630.78 Typical High $6,760.83 | Facility | None | $1,659.59 | $3,630.78 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $3,311.31 | Professional | None | $977.24 | $1,479.11 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,380.38 | $2,041.74 | $2,041.74 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $8,511.38 Typical High $23,988.33 | Facility | None | $4,466.84 | $8,511.38 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $4,073.80 | Professional | None | $1,348.96 | $1,621.81 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $3,090.30 | Professional | None | $954.99 | $1,288.25 | $3,090.30 |
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 $794.33 | Professional | 52 · Reduced service | $630.96 | $630.96 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $323.59 | Professional | 53 · Discontinued | $251.19 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $239.88 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $162.18 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,122.02 |
Where New Jersey sits
The same service costs 6.5 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
$1,622
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.