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 $891.25 Median $891.25 Typical High $1,023.29 | Professional | None | $891.25 | $891.25 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,318.26 Typical High $2,691.53 | Facility | None | $691.83 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $2,290.87 | Professional | None | $741.31 | $812.83 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,148.15 | Professional | None | $851.14 | $1,122.02 | $1,148.15 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $2,238.72 Typical High $5,888.44 | Facility | None | $1,258.93 | $2,238.72 | $5,888.44 |
Horizon BCBS Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $2,454.71 | Professional | None | $831.76 | $977.24 | $2,454.71 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $3,981.07 | Facility | None | $537.03 | $1,548.82 | $3,981.07 |
United Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $2,570.40 | Professional | None | $741.31 | $933.25 | $2,570.40 |
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 $446.68 Median $446.68 Typical High $512.86 | Professional | 52 · Reduced service | $446.68 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | 53 · Discontinued | $177.83 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $776.25 | Professional | 54 · Surgery only | $676.08 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $724.44 |
Where New Jersey sits
The same service costs 4.4 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· 35th of 51
$1,023
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.