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 $2,754.23 Median $5,754.40 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,754.40 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $562.34 | Professional | None | $331.13 | $457.09 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,137.96 Typical High $3,311.31 | Facility | None | $933.25 | $2,137.96 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $776.25 | Professional | None | $251.19 | $407.38 | $776.25 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $870.96 | Professional | None | $602.56 | $812.83 | $870.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,801.89 Typical High $12,589.25 | Facility | None | $2,137.96 | $3,801.89 | $12,589.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $346.74 Median $602.56 Typical High $870.96 | Professional | None | $346.74 | $602.56 | $870.96 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,754.40 | Facility | None | $707.95 | $1,995.26 | $5,754.40 |
United Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $707.95 | Professional | None | $213.80 | $354.81 | $707.95 |
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 $165.96 Median $229.09 Typical High $263.03 | Professional | 52 · Reduced service | $165.96 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $91.20 Typical High $104.71 | Professional | 53 · Discontinued | $66.07 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $338.84 Typical High $389.05 | Professional | 54 · Surgery only | $245.47 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $48.98 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $45.71 Typical High $52.48 | Professional | 56 · Pre-op care only | $33.11 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $316.23 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $229.09 | $316.23 | $363.08 |
Where New Jersey sits
The same service costs 4.4 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· 46th of 51
$468
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.