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 $1,995.26 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,995.26 | $1,995.26 | $2,454.71 |
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 $1,949.84 Median $2,089.30 Typical High $5,128.61 | Professional | None | $1,949.84 | $2,089.30 | $5,128.61 |
Emblem Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,019.95 Typical High $3,090.30 | Professional | None | $2,238.72 | $3,019.95 | $3,090.30 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $6,025.60 | Professional | None | $1,949.84 | $2,290.87 | $6,025.60 |
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 $1,819.70 Median $2,344.23 Typical High $6,025.60 | Professional | None | $1,819.70 | $2,344.23 | $6,025.60 |
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 $977.24 Median $977.24 Typical High $1,230.27 | Professional | 52 · Reduced service | $977.24 | $977.24 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $489.78 | Professional | 53 · Discontinued | $398.11 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $363.08 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $245.47 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,698.24 |
Where New Jersey sits
The same service costs 5.2 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
$2,188
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.