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 $691.83 Median $691.83 Typical High $794.33 | Professional | None | $691.83 | $691.83 | $794.33 |
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 $524.81 Median $537.03 Typical High $1,202.26 | Professional | None | $524.81 | $537.03 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,202.26 | Professional | None | $812.83 | $1,122.02 | $1,202.26 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,511.38 Typical High $23,988.33 | Facility | None | $4,786.30 | $8,511.38 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,174.90 | Professional | None | $691.83 | $831.76 | $1,174.90 |
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 $436.52 Median $537.03 Typical High $758.58 | Professional | None | $436.52 | $537.03 | $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 $346.74 Median $346.74 Typical High $371.54 | Professional | 52 · Reduced service | $346.74 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $138.04 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $562.34 | Professional | 54 · Surgery only | $512.86 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $524.81 |
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
$692
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.