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 $4,466.84 Median $7,244.36 Typical High $12,882.50 | Facility | None | $4,466.84 | $7,244.36 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $575.44 | Professional | None | $489.78 | $489.78 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,311.31 Typical High $5,128.61 | Facility | None | $1,318.26 | $3,311.31 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $1,174.90 | Professional | None | $323.59 | $446.68 | $1,174.90 |
Emblem Health Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $758.58 | Professional | None | $562.34 | $758.58 | $758.58 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $11,748.98 | Facility | None | $1,949.84 | $3,548.13 | $11,748.98 |
Horizon BCBS Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $1,445.44 | Professional | None | $457.09 | $537.03 | $1,445.44 |
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 $436.52 Median $549.54 Typical High $1,445.44 | Professional | None | $436.52 | $549.54 | $1,445.44 |
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 $245.47 Median $245.47 Typical High $275.42 | Professional | 52 · Reduced service | $245.47 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $389.05 |
Where New Jersey sits
The same service costs 5.4 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· 31st of 51
$813
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.