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 $7,413.10 Typical High $13,489.63 | Facility | None | $4,466.84 | $7,413.10 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,122.02 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $6,309.57 Typical High $11,220.18 | Facility | None | $1,995.26 | $6,309.57 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,949.84 | Professional | None | $831.76 | $1,023.29 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,862.09 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,862.09 | $2,089.30 |
Horizon BCBS Setting Facility Modifier None Typical Low $8,128.31 Median $14,454.40 Typical High $39,810.72 | Facility | None | $8,128.31 | $14,454.40 | $39,810.72 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,202.26 | $1,412.54 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $5,754.40 Typical High $13,803.84 | Facility | None | $1,659.59 | $5,754.40 | $13,803.84 |
United Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,318.26 | Professional | None | $724.44 | $891.25 | $1,318.26 |
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 $562.34 Median $562.34 Typical High $630.96 | Professional | 52 · Reduced service | $562.34 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | 53 · Discontinued | $223.87 | $223.87 | $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 $112.20 Median $112.20 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $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 25.7 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
$1,122
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.