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 $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | None | $870.96 | $870.96 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $2,570.40 Typical High $3,801.89 | Facility | None | $1,230.27 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $676.08 Typical High $1,548.82 | Professional | None | $660.69 | $676.08 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,380.38 | $1,513.56 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,801.89 Typical High $13,489.63 | Facility | None | $2,137.96 | $3,801.89 | $13,489.63 |
Horizon BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,479.11 | Professional | None | $933.25 | $1,122.02 | $1,479.11 |
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 $537.03 Median $676.08 Typical High $1,023.29 | Professional | None | $537.03 | $676.08 | $1,023.29 |
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 $436.52 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $436.52 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $645.65 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $660.69 |
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· 48th of 51
$871
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.