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 $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $467.74 | Professional | None | $380.19 | $380.19 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,949.84 Typical High $3,311.31 | Facility | None | $691.83 | $1,949.84 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $741.31 | Professional | None | $323.59 | $331.13 | $741.31 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $758.58 | Professional | None | $512.86 | $707.95 | $758.58 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $3,801.89 Typical High $12,589.25 | Facility | None | $2,187.76 | $3,801.89 | $12,589.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $707.95 | Professional | None | $436.52 | $524.81 | $707.95 |
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 $269.15 Median $323.59 Typical High $467.74 | Professional | None | $269.15 | $323.59 | $467.74 |
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 $190.55 Median $190.55 Typical High $229.09 | Professional | 52 · Reduced service | $190.55 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $91.20 | Professional | 53 · Discontinued | $75.86 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 54 · Surgery only | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $67.61 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $316.23 |
Where New Jersey sits
The same service costs 6.2 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· 47th of 51
$380
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.