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 $912.01 Median $912.01 Typical High $1,071.52 | Professional | None | $912.01 | $912.01 | $1,071.52 |
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 $707.95 Median $870.96 Typical High $1,659.59 | Professional | None | $707.95 | $870.96 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,584.89 | $1,778.28 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,981.07 | Facility | None | $3,019.95 | $3,019.95 | $3,981.07 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,202.26 | $1,584.89 |
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 $630.96 Median $758.58 Typical High $1,122.02 | Professional | None | $630.96 | $758.58 | $1,122.02 |
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 $457.09 Median $457.09 Typical High $524.81 | Professional | 52 · Reduced service | $457.09 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $213.80 | Professional | 53 · Discontinued | $181.97 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $794.33 | Professional | 54 · Surgery only | $691.83 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $104.71 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $741.31 |
Where New Jersey sits
The same service costs 24.5 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
$912
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.