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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,412.54 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $3,467.37 Typical High $6,760.83 | Facility | None | $933.25 | $3,467.37 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $4,073.80 | Professional | None | $1,230.27 | $1,778.28 | $4,073.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,737.80 | $2,570.40 | $2,570.40 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,317.64 Typical High $23,988.33 | Facility | None | $4,677.35 | $8,317.64 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $4,897.79 | Professional | None | $1,659.59 | $1,995.26 | $4,897.79 |
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 $1,230.27 Median $1,584.89 Typical High $3,801.89 | Professional | None | $1,230.27 | $1,584.89 | $3,801.89 |
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 $707.95 Median $707.95 Typical High $933.25 | Professional | 52 · Reduced service | $707.95 | $707.95 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $380.19 | Professional | 53 · Discontinued | $281.84 | $281.84 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $281.84 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $186.21 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,318.26 |
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· 38th of 51
$1,995
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.