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 $2,454.71 Median $2,454.71 Typical High $2,754.23 | Professional | None | $2,454.71 | $2,454.71 | $2,754.23 |
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 $2,187.76 Median $2,344.23 Typical High $6,309.57 | Professional | None | $2,187.76 | $2,344.23 | $6,309.57 |
Emblem Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,311.31 Typical High $3,388.44 | Professional | None | $2,398.83 | $3,311.31 | $3,388.44 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $6,918.31 | Professional | None | $2,187.76 | $2,570.40 | $6,918.31 |
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 $2,041.74 Median $2,630.27 Typical High $6,918.31 | Professional | None | $2,041.74 | $2,630.27 | $6,918.31 |
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 $1,230.27 Median $1,230.27 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $549.54 | Professional | 53 · Discontinued | $489.78 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $416.87 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $275.42 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $1,949.84 |
Where New Jersey sits
The same service costs 6.9 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· 40th of 51
$2,455
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.