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 $977.24 Median $6,918.31 Typical High $12,022.64 | Facility | None | $977.24 | $6,918.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,096.48 | Professional | None | $977.24 | $977.24 | $1,096.48 |
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 $741.31 Median $758.58 Typical High $1,737.80 | Professional | None | $741.31 | $758.58 | $1,737.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,548.82 | $1,698.24 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $8,709.64 Typical High $23,988.33 | Facility | None | $4,466.84 | $8,709.64 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,258.93 | $1,659.59 |
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 $602.56 Median $776.25 Typical High $1,148.15 | Professional | None | $602.56 | $776.25 | $1,148.15 |
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 $489.78 Median $489.78 Typical High $537.03 | Professional | 52 · Reduced service | $489.78 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | 53 · Discontinued | $199.53 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $794.33 | Professional | 54 · Surgery only | $741.31 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $158.49 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $741.31 |
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
$977
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.