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 $812.83 Median $812.83 Typical High $1,288.25 | Professional | None | $812.83 | $812.83 | $1,288.25 |
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 $831.76 Median $1,148.15 Typical High $2,511.89 | Professional | None | $831.76 | $1,148.15 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,737.80 | $1,737.80 |
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 $1,122.02 Median $1,348.96 Typical High $3,090.30 | Professional | None | $1,122.02 | $1,348.96 | $3,090.30 |
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 $776.25 Median $1,071.52 Typical High $2,630.27 | Professional | None | $776.25 | $1,071.52 | $2,630.27 |
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 $398.11 Median $398.11 Typical High $645.65 | Professional | 52 · Reduced service | $398.11 | $398.11 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $257.04 | Professional | 53 · Discontinued | $162.18 | $162.18 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $977.24 | Professional | 54 · Surgery only | $602.56 | $602.56 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $194.98 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $128.82 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $912.01 |
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
$1,349
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.