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 $831.76 Median $831.76 Typical High $1,096.48 | Professional | None | $831.76 | $831.76 | $1,096.48 |
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 $954.99 Median $1,096.48 Typical High $2,630.27 | Professional | None | $954.99 | $1,096.48 | $2,630.27 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,513.56 | $1,513.56 |
Horizon BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $2,754.23 | Professional | None | $933.25 | $1,096.48 | $2,754.23 |
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 $707.95 Median $912.01 Typical High $2,137.96 | Professional | None | $707.95 | $912.01 | $2,137.96 |
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 $416.87 Median $416.87 Typical High $549.54 | Professional | 52 · Reduced service | $416.87 | $416.87 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | 53 · Discontinued | $165.96 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $812.83 | Professional | 54 · Surgery only | $616.60 | $616.60 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $162.18 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $758.58 |
Where New Jersey sits
The same service costs 6.8 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
$1,047
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.