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 $3,801.89 Median $7,943.28 Typical High $12,022.64 | Facility | None | $3,801.89 | $7,943.28 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,258.93 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $3,981.07 Typical High $6,760.83 | Facility | None | $1,513.56 | $3,981.07 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $2,818.38 | Professional | None | $794.33 | $1,258.93 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,630.27 | $2,630.27 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,511.38 Typical High $22,387.21 | Facility | None | $4,677.35 | $8,511.38 | $22,387.21 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $4,073.80 | Professional | None | $1,122.02 | $1,737.80 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,258.93 Typical High $3,235.94 | Professional | None | $776.25 | $1,258.93 | $3,235.94 |
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 $512.86 Median $630.96 Typical High $758.58 | Professional | 52 · Reduced service | $512.86 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $251.19 Typical High $302.00 | Professional | 53 · Discontinued | $204.17 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $933.25 Typical High $1,122.02 | Professional | 54 · Surgery only | $776.25 | $933.25 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $186.21 Typical High $229.09 | Professional | 55 · Aftercare only | $154.88 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $125.89 Typical High $151.36 | Professional | 56 · Pre-op care only | $102.33 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $870.96 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $724.44 | $870.96 | $1,047.13 |
Where New Jersey sits
The same service costs 5.2 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· 43rd of 51
$1,514
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.