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 $9,332.54 Typical High $14,125.38 | Facility | None | $4,466.84 | $9,332.54 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $741.31 | Professional | None | $645.65 | $645.65 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $4,265.80 Typical High $6,760.83 | Facility | None | $1,548.82 | $4,265.80 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $1,148.15 | Professional | None | $478.63 | $501.19 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,148.15 | Professional | None | $776.25 | $1,047.13 | $1,148.15 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,912.51 Typical High $23,988.33 | Facility | None | $4,786.30 | $8,912.51 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,096.48 | Professional | None | $691.83 | $831.76 | $1,096.48 |
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 $407.38 Median $501.19 Typical High $758.58 | Professional | None | $407.38 | $501.19 | $758.58 |
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 $323.59 Median $323.59 Typical High $346.74 | Professional | 52 · Reduced service | $323.59 | $323.59 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $138.04 | Professional | 53 · Discontinued | $128.82 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $524.81 | Professional | 54 · Surgery only | $489.78 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $104.71 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $69.18 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $489.78 |
Where New Jersey sits
The same service costs 6.3 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
$646
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.