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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | None | $371.54 | $371.54 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $3,388.44 Typical High $6,456.54 | Facility | None | $933.25 | $3,388.44 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $870.96 | Professional | None | $416.87 | $416.87 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $645.65 | Professional | None | $478.63 | $645.65 | $645.65 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $5,754.40 Typical High $15,135.61 | Facility | None | $3,090.30 | $5,754.40 | $15,135.61 |
Horizon BCBS Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $1,174.90 | Professional | None | $398.11 | $467.74 | $1,174.90 |
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 $371.54 Median $467.74 Typical High $1,230.27 | Professional | None | $371.54 | $467.74 | $1,230.27 |
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 $186.21 Median $186.21 Typical High $234.42 | Professional | 52 · Reduced service | $186.21 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $93.33 | Professional | 53 · Discontinued | $75.86 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $346.74 | Professional | 54 · Surgery only | $281.84 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $69.18 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $46.77 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $323.59 |
Where New Jersey sits
The same service costs 5.4 times more in Alaska than in New York. 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· 29th of 51
$692
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.