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 $812.83 Median $812.83 Typical High $933.25 | Professional | None | $812.83 | $812.83 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $2,691.53 Typical High $33,113.11 | Facility | None | $1,513.56 | $2,691.53 | $33,113.11 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $2,089.30 | Professional | None | $758.58 | $812.83 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,230.27 | Professional | None | $912.01 | $1,230.27 | $1,230.27 |
Horizon BCBS Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $2,290.87 | Professional | None | $741.31 | $870.96 | $2,290.87 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,754.40 | Facility | None | $331.13 | $1,479.11 | $5,754.40 |
United Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $2,344.23 | Professional | None | $707.95 | $912.01 | $2,344.23 |
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 $407.38 Median $407.38 Typical High $436.52 | Professional | 52 · Reduced service | $407.38 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $177.83 | Professional | 53 · Discontinued | $165.96 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $660.69 | Professional | 54 · Surgery only | $616.60 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $616.60 |
Where New Jersey sits
The same service costs 4.6 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· 43rd of 51
$891
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.