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 $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,148.15 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $3,890.45 Typical High $7,079.46 | Facility | None | $1,995.26 | $3,890.45 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $2,951.21 | Professional | None | $954.99 | $1,047.13 | $2,951.21 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,445.44 | $1,513.56 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $7,762.47 Typical High $22,387.21 | Facility | None | $4,265.80 | $7,762.47 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $3,162.28 | Professional | None | $954.99 | $1,122.02 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,220.18 | Facility | None | $1,621.81 | $4,897.79 | $11,220.18 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $3,019.95 | Professional | None | $912.01 | $1,202.26 | $3,019.95 |
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 $575.44 Median $575.44 Typical High $676.08 | Professional | 52 · Reduced service | $575.44 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | 53 · Discontinued | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $204.17 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $933.25 |
Where New Jersey sits
The same service costs 5.1 times more in Wisconsin 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· 37th of 51
$1,514
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.