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 $6,606.93 Typical High $11,481.54 | Facility | None | $2,754.23 | $6,606.93 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $912.01 | Professional | None | $562.34 | $724.44 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,630.78 Typical High $6,760.83 | Facility | None | $1,174.90 | $3,630.78 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $1,698.24 | Professional | None | $457.09 | $741.31 | $1,698.24 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,348.96 | Professional | None | $954.99 | $1,348.96 | $1,348.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,317.64 Typical High $22,387.21 | Facility | None | $4,677.35 | $8,317.64 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,071.52 Typical High $2,454.71 | Professional | None | $645.65 | $1,071.52 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,918.31 | Facility | None | $1,122.02 | $2,884.03 | $6,918.31 |
United Setting Professional Modifier None Typical Low $407.38 Median $676.08 Typical High $1,778.28 | Professional | None | $407.38 | $676.08 | $1,778.28 |
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 $281.84 Median $363.08 Typical High $457.09 | Professional | 52 · Reduced service | $281.84 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $144.54 Typical High $181.97 | Professional | 53 · Discontinued | $112.20 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $537.03 Typical High $676.08 | Professional | 54 · Surgery only | $426.58 | $537.03 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $109.65 Typical High $138.04 | Professional | 55 · Aftercare only | $85.11 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $72.44 Typical High $91.20 | Professional | 56 · Pre-op care only | $56.23 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $501.19 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $398.11 | $501.19 | $630.96 |
Where New Jersey sits
The same service costs 5.2 times more in Alaska than in Utah. 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· 40th of 51
$912
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.