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 $3,548.13 Median $3,548.13 Typical High $4,168.69 | Professional | None | $3,548.13 | $3,548.13 | $4,168.69 |
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 $2,818.38 Median $3,388.44 Typical High $6,456.54 | Professional | None | $2,818.38 | $3,388.44 | $6,456.54 |
Emblem Health Setting Professional Modifier None Typical Low $4,677.35 Median $6,165.95 Typical High $6,918.31 | Professional | None | $4,677.35 | $6,165.95 | $6,918.31 |
Horizon BCBS Setting Professional Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $6,165.95 | Professional | None | $4,073.80 | $4,786.30 | $6,165.95 |
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 $2,398.83 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,398.83 | $2,951.21 | $4,466.84 |
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 $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $851.14 | Professional | 53 · Discontinued | $707.95 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $2,951.21 |
Where New Jersey sits
The same service costs 21.9 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· 46th of 51
$3,548
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.