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 $1,096.48 Median $1,096.48 Typical High $1,174.90 | Professional | None | $1,096.48 | $1,096.48 | $1,174.90 |
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 $933.25 Median $1,023.29 Typical High $2,630.27 | Professional | None | $933.25 | $1,023.29 | $2,630.27 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,412.54 | $1,445.44 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,365.16 Median $8,128.31 Typical High $20,892.96 | Facility | None | $4,365.16 | $8,128.31 | $20,892.96 |
Horizon BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $2,884.03 | Professional | None | $933.25 | $1,096.48 | $2,884.03 |
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 $870.96 Median $1,148.15 Typical High $2,884.03 | Professional | None | $870.96 | $1,148.15 | $2,884.03 |
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 $549.54 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $229.09 | Professional | 53 · Discontinued | $218.78 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $851.14 | Professional | 54 · Surgery only | $812.83 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $169.82 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $114.82 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $794.33 |
Where New Jersey sits
The same service costs 5.0 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· 38th of 51
$1,445
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.