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 $4,365.16 Median $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $562.34 | Professional | None | $489.78 | $489.78 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,148.15 Typical High $1,778.28 | Facility | None | $691.83 | $1,148.15 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $912.01 | Professional | None | $380.19 | $457.09 | $912.01 |
Emblem Health Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $977.24 | Professional | None | $660.69 | $870.96 | $977.24 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,238.72 Typical High $6,309.57 | Facility | None | $1,174.90 | $2,238.72 | $6,309.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $870.96 | Professional | None | $524.81 | $645.65 | $870.96 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $602.56 | Professional | None | $346.74 | $416.87 | $602.56 |
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 $245.47 Median $245.47 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | 54 · Surgery only | $363.08 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $398.11 |
Where New Jersey sits
The same service costs 5.5 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
$490
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.