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 $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,621.81 | $1,621.81 | $1,819.70 |
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 $1,479.11 Median $1,621.81 Typical High $4,073.80 | Professional | None | $1,479.11 | $1,621.81 | $4,073.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,290.87 Typical High $2,344.23 | Professional | None | $1,621.81 | $2,290.87 | $2,344.23 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $4,466.84 | Professional | None | $1,479.11 | $1,737.80 | $4,466.84 |
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 $1,380.38 Median $1,778.28 Typical High $4,570.88 | Professional | None | $1,380.38 | $1,778.28 | $4,570.88 |
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 $812.83 Median $812.83 Typical High $870.96 | Professional | 52 · Reduced service | $812.83 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $346.74 | Professional | 53 · Discontinued | $323.59 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $263.03 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $173.78 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,230.27 |
Where New Jersey sits
The same service costs 6.0 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· 38th of 51
$1,698
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.