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 $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $630.96 | Professional | None | $501.19 | $501.19 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,290.87 Typical High $3,311.31 | Facility | None | $1,174.90 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $954.99 | Professional | None | $416.87 | $512.86 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,071.52 | Professional | None | $741.31 | $977.24 | $1,071.52 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $4,073.80 Typical High $10,471.29 | Facility | None | $2,290.87 | $4,073.80 | $10,471.29 |
Horizon BCBS Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $933.25 | Professional | None | $602.56 | $707.95 | $933.25 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $660.69 | Professional | None | $380.19 | $457.09 | $660.69 |
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 $251.19 Median $251.19 Typical High $309.03 | Professional | 52 · Reduced service | $251.19 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | 53 · Discontinued | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $467.74 | Professional | 54 · Surgery only | $380.19 | $380.19 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $93.33 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $61.66 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $436.52 |
Where New Jersey sits
The same service costs 5.6 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
$537
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.