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 $1,659.59 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 $912.01 Median $1,000.00 Typical High $2,818.38 | Professional | None | $912.01 | $1,000.00 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,412.54 | Professional | None | $977.24 | $1,380.38 | $1,412.54 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,677.35 Typical High $12,882.50 | Facility | None | $2,511.89 | $4,677.35 | $12,882.50 |
Horizon BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $2,884.03 | Professional | None | $912.01 | $1,071.52 | $2,884.03 |
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 $851.14 Median $1,122.02 Typical High $2,818.38 | Professional | None | $851.14 | $1,122.02 | $2,818.38 |
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 $588.84 | Professional | 52 · Reduced service | $549.54 | $549.54 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | 53 · Discontinued | $218.78 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $812.83 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $117.49 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $831.76 |
Where New Jersey sits
The same service costs 4.6 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· 36th of 51
$1,380
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.