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 $6,918.31 Typical High $11,481.54 | Facility | None | $4,466.84 | $6,918.31 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $741.31 | Professional | None | $645.65 | $660.69 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,570.40 Typical High $3,715.35 | Facility | None | $1,174.90 | $2,570.40 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $602.56 Typical High $1,479.11 | Professional | None | $380.19 | $602.56 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $851.14 | Professional | None | $630.96 | $831.76 | $851.14 |
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 $549.54 Median $645.65 Typical High $1,862.09 | Professional | None | $549.54 | $645.65 | $1,862.09 |
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 $512.86 Median $676.08 Typical High $1,698.24 | Professional | None | $512.86 | $676.08 | $1,698.24 |
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 $323.59 Median $331.13 Typical High $371.54 | Professional | 52 · Reduced service | $323.59 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $147.91 | Professional | 53 · Discontinued | $128.82 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $74.13 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $524.81 |
Where New Jersey sits
The same service costs 5.9 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· 33rd of 51
$955
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.