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 $1,318.26 Median $1,348.96 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,348.96 | $2,290.87 |
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 $1,202.26 Median $1,288.25 Typical High $3,311.31 | Professional | None | $1,202.26 | $1,288.25 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,905.46 | $1,949.84 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $3,630.78 | Professional | None | $1,202.26 | $1,412.54 | $3,630.78 |
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 $1,122.02 Median $1,445.44 Typical High $3,715.35 | Professional | None | $1,122.02 | $1,445.44 | $3,715.35 |
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 $660.69 Median $660.69 Typical High $707.95 | Professional | 52 · Reduced service | $660.69 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $281.84 | Professional | 53 · Discontinued | $263.03 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,000.00 |
Where New Jersey sits
The same service costs 4.8 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· 42nd of 51
$1,413
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.