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 $1,023.29 Median $1,023.29 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,023.29 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $2,570.40 Typical High $3,630.78 | Facility | None | $1,659.59 | $2,570.40 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $2,454.71 | Professional | None | $891.25 | $977.24 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $1,380.38 | Professional | None | $977.24 | $1,348.96 | $1,380.38 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,677.35 Typical High $11,748.98 | Facility | None | $2,511.89 | $4,677.35 | $11,748.98 |
Horizon BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $2,951.21 | Professional | None | $891.25 | $1,047.13 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $2,754.23 | Professional | None | $831.76 | $1,071.52 | $2,754.23 |
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 $512.86 Median $512.86 Typical High $616.60 | Professional | 52 · Reduced service | $512.86 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $245.47 | Professional | 53 · Discontinued | $204.17 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $870.96 |
Where New Jersey sits
The same service costs 4.7 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
$1,349
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.