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 $1,445.44 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,445.44 | $1,445.44 | $1,621.81 |
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 $1,318.26 Median $1,412.54 Typical High $3,630.78 | Professional | None | $1,318.26 | $1,412.54 | $3,630.78 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,445.44 | $2,089.30 | $2,089.30 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $3,981.07 | Professional | None | $1,288.25 | $1,513.56 | $3,981.07 |
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 $1,230.27 Median $1,584.89 Typical High $4,073.80 | Professional | None | $1,230.27 | $1,584.89 | $4,073.80 |
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 $724.44 Median $724.44 Typical High $776.25 | Professional | 52 · Reduced service | $724.44 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $309.03 | Professional | 53 · Discontinued | $288.40 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $229.09 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $154.88 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,071.52 |
Where New Jersey sits
The same service costs 5.4 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
$1,514
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.