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 $1,778.28 Median $1,778.28 Typical High $2,041.74 | Professional | None | $1,778.28 | $1,778.28 | $2,041.74 |
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 $1,659.59 Median $1,737.80 Typical High $4,466.84 | Professional | None | $1,659.59 | $1,737.80 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,570.40 Typical High $2,630.27 | Professional | None | $1,949.84 | $2,570.40 | $2,630.27 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $5,011.87 | Professional | None | $1,621.81 | $1,905.46 | $5,011.87 |
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 $1,548.82 Median $1,995.26 Typical High $5,128.61 | Professional | None | $1,548.82 | $1,995.26 | $5,128.61 |
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 $891.25 Median $891.25 Typical High $977.24 | Professional | 52 · Reduced service | $891.25 | $891.25 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $389.05 | Professional | 53 · Discontinued | $354.81 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $194.98 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,348.96 |
Where New Jersey sits
The same service costs 5.8 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· 39th of 51
$1,905
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.