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 $9,120.11 Typical High $28,840.32 | Facility | None | $4,466.84 | $9,120.11 | $28,840.32 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,778.28 | Professional | None | $1,548.82 | $1,548.82 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $4,786.30 | Facility | None | $1,071.52 | $2,137.96 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,445.44 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,691.53 Typical High $2,951.21 | Professional | None | $1,995.26 | $2,691.53 | $2,951.21 |
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 $1,698.24 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,698.24 | $2,041.74 | $3,090.30 |
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 $1,047.13 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,258.93 | $1,905.46 |
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 $776.25 Median $776.25 Typical High $891.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | 53 · Discontinued | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $177.83 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,230.27 |
Where New Jersey sits
The same service costs 5.4 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· 49th of 51
$1,549
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.