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 $1,148.15 Median $1,148.15 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,148.15 | $1,318.26 |
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 $870.96 Median $1,047.13 Typical High $2,041.74 | Professional | None | $870.96 | $1,047.13 | $2,041.74 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,905.46 | $2,137.96 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,479.11 | $1,949.84 |
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 $758.58 Median $912.01 Typical High $1,380.38 | Professional | None | $758.58 | $912.01 | $1,380.38 |
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 $575.44 Median $575.44 Typical High $645.65 | Professional | 52 · Reduced service | $575.44 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | 53 · Discontinued | $229.09 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $977.24 | Professional | 54 · Surgery only | $851.14 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $912.01 |
Where New Jersey sits
The same service costs 5.4 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
$1,148
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.