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 $7,079.46 Typical High $11,748.98 | Facility | None | $2,754.23 | $7,079.46 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $831.76 | Professional | None | $630.96 | $758.58 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $6,760.83 | Facility | None | $1,318.26 | $3,890.45 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $1,258.93 | Professional | None | $457.09 | $602.56 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,380.38 | $1,445.44 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $8,912.51 Typical High $23,988.33 | Facility | None | $4,466.84 | $8,912.51 | $23,988.33 |
Horizon BCBS Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,412.54 | Professional | None | $616.60 | $954.99 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,918.31 | Facility | None | $1,122.02 | $2,884.03 | $6,918.31 |
United Setting Professional Modifier None Typical Low $389.05 Median $575.44 Typical High $812.83 | Professional | None | $389.05 | $575.44 | $812.83 |
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 $316.23 Median $380.19 Typical High $416.87 | Professional | 52 · Reduced service | $316.23 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $151.36 Typical High $165.96 | Professional | 53 · Discontinued | $125.89 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $575.44 Typical High $616.60 | Professional | 54 · Surgery only | $467.74 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $114.82 Typical High $123.03 | Professional | 55 · Aftercare only | $93.33 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $83.18 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $537.03 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $436.52 | $537.03 | $575.44 |
Where New Jersey sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 51st of 51
$631
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.