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 $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $912.01 | Professional | None | $707.95 | $707.95 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,071.52 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $912.01 Typical High $1,949.84 | Professional | None | $537.03 | $912.01 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,258.93 | Professional | None | $891.25 | $1,258.93 | $1,258.93 |
Horizon BCBS Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $2,238.72 | Professional | None | $758.58 | $912.01 | $2,238.72 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,495.41 | Facility | None | $331.13 | $1,479.11 | $5,495.41 |
United Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,778.28 | Professional | None | $588.84 | $776.25 | $1,778.28 |
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 $346.74 Median $346.74 Typical High $446.68 | Professional | 52 · Reduced service | $346.74 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $181.97 | Professional | 53 · Discontinued | $141.25 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $676.08 | Professional | 54 · Surgery only | $524.81 | $524.81 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $134.90 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $91.20 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $630.96 |
Where New Jersey sits
The same service costs 6.2 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· 42nd of 51
$871
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.