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 $1,445.44 Median $1,445.44 Typical High $1,659.59 | Professional | None | $1,445.44 | $1,445.44 | $1,659.59 |
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 $1,348.96 Median $1,479.11 Typical High $3,715.35 | Professional | None | $1,348.96 | $1,479.11 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $2,137.96 | Professional | None | $1,479.11 | $2,089.30 | $2,137.96 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $3,981.07 | Professional | None | $1,318.26 | $1,548.82 | $3,981.07 |
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 $1,230.27 Median $1,621.81 Typical High $4,168.69 | Professional | None | $1,230.27 | $1,621.81 | $4,168.69 |
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 $724.44 Median $724.44 Typical High $776.25 | Professional | 52 · Reduced service | $724.44 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $316.23 | Professional | 53 · Discontinued | $288.40 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $234.42 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $158.49 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,096.48 |
Where New Jersey sits
The same service costs 5.4 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
$1,549
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.