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 $3,388.44 Median $3,388.44 Typical High $5,888.44 | Professional | None | $3,388.44 | $3,388.44 | $5,888.44 |
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 $3,090.30 Median $3,235.94 Typical High $8,511.38 | Professional | None | $3,090.30 | $3,235.94 | $8,511.38 |
Emblem Health Setting Professional Modifier None Typical Low $3,388.44 Median $4,786.30 Typical High $4,786.30 | Professional | None | $3,388.44 | $4,786.30 | $4,786.30 |
Horizon BCBS Setting Professional Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $9,332.54 | Professional | None | $3,019.95 | $3,548.13 | $9,332.54 |
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 $2,884.03 Median $3,715.35 Typical High $9,549.93 | Professional | None | $2,884.03 | $3,715.35 | $9,549.93 |
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 $1,698.24 Median $1,698.24 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,698.24 | $1,698.24 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $676.08 Typical High $724.44 | Professional | 53 · Discontinued | $676.08 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,511.89 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,511.89 | $2,511.89 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $501.19 Typical High $549.54 | Professional | 55 · Aftercare only | $501.19 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $338.84 Typical High $363.08 | Professional | 56 · Pre-op care only | $338.84 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,344.23 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,344.23 | $2,570.40 |
Where New Jersey sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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· 39th of 51
$3,388
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.