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 $8,511.38 Typical High $28,183.83 | Facility | None | $4,365.16 | $8,511.38 | $28,183.83 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,096.48 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $3,019.95 | Facility | None | $1,071.52 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,995.26 | Professional | None | $851.14 | $1,047.13 | $1,995.26 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,905.46 | $2,137.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,445.44 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,073.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,348.96 | Professional | None | $741.31 | $891.25 | $1,348.96 |
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 $549.54 Median $549.54 Typical High $630.96 | Professional | 52 · Reduced service | $549.54 | $549.54 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 53 · Discontinued | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $190.55 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $125.89 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $870.96 |
Where New Jersey sits
The same service costs 26.3 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
$1,096
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.