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 $389.05 Median $5,888.44 Typical High $10,471.29 | Facility | None | $389.05 | $5,888.44 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,258.93 Typical High $1,659.59 | Professional | None | $371.54 | $1,258.93 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,570.40 Typical High $3,715.35 | Facility | None | $1,548.82 | $2,570.40 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $912.01 Typical High $2,238.72 | Professional | None | $309.03 | $912.01 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,479.11 | $2,238.72 | $2,238.72 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $11,748.98 | Facility | None | $2,691.53 | $4,786.30 | $11,748.98 |
Horizon BCBS Setting Professional Modifier None Typical Low $363.08 Median $1,548.82 Typical High $3,890.45 | Professional | None | $363.08 | $1,548.82 | $3,890.45 |
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 $1,174.90 Typical High $2,344.23 | Professional | None | $371.54 | $1,174.90 | $2,344.23 |
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 $426.58 Typical High $741.31 | Professional | 52 · Reduced service | $186.21 | $426.58 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $169.82 Typical High $295.12 | Professional | 53 · Discontinued | $74.13 | $169.82 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $630.96 Typical High $1,122.02 | Professional | 54 · Surgery only | $281.84 | $630.96 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $128.82 Typical High $223.87 | Professional | 55 · Aftercare only | $56.23 | $128.82 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $85.11 Typical High $147.91 | Professional | 56 · Pre-op care only | $37.15 | $85.11 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $588.84 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $263.03 | $588.84 | $1,047.13 |
Where New Jersey sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 24th 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.