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 $954.99 Median $954.99 Typical High $1,071.52 | Professional | None | $954.99 | $954.99 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,071.52 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,698.24 | Professional | None | $660.69 | $794.33 | $1,698.24 |
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 Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,513.56 | Professional | None | $933.25 | $1,122.02 | $1,513.56 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,495.41 | Facility | None | $331.13 | $1,479.11 | $5,495.41 |
United Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,096.48 | Professional | None | $602.56 | $741.31 | $1,096.48 |
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 $478.63 Median $478.63 Typical High $501.19 | Professional | 52 · Reduced service | $478.63 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | 53 · Discontinued | $190.55 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $707.95 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $707.95 |
Where New Jersey sits
The same service costs 24.5 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· 47th of 51
$933
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.