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 $851.14 Median $851.14 Typical High $1,096.48 | Professional | None | $851.14 | $851.14 | $1,096.48 |
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 $691.83 Median $831.76 Typical High $1,584.89 | Professional | None | $691.83 | $831.76 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,584.89 | $1,737.80 |
Horizon BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,513.56 | Professional | None | $977.24 | $1,148.15 | $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 $616.60 Median $741.31 Typical High $1,071.52 | Professional | None | $616.60 | $741.31 | $1,071.52 |
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 $426.58 Median $426.58 Typical High $501.19 | Professional | 52 · Reduced service | $426.58 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $199.53 | Professional | 53 · Discontinued | $169.82 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | 54 · Surgery only | $630.96 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $707.95 |
Where New Jersey sits
The same service costs 4.9 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
$851
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.