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 $602.56 Median $6,918.31 Typical High $11,748.98 | Facility | None | $602.56 | $6,918.31 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $707.95 | Professional | None | $524.81 | $524.81 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $3,981.07 | Facility | None | $1,318.26 | $2,754.23 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $977.24 | Professional | None | $416.87 | $501.19 | $977.24 |
Emblem Health Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,047.13 | Professional | None | $707.95 | $954.99 | $1,047.13 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,248.07 Typical High $13,489.63 | Facility | None | $2,951.21 | $5,248.07 | $13,489.63 |
Horizon BCBS Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $912.01 | Professional | None | $588.84 | $691.83 | $912.01 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $660.69 | Professional | None | $371.54 | $446.68 | $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 $263.03 Median $263.03 Typical High $309.03 | Professional | 52 · Reduced service | $263.03 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $123.03 | Professional | 53 · Discontinued | $104.71 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $457.09 | Professional | 54 · Surgery only | $398.11 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $93.33 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $61.66 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $426.58 |
Where New Jersey sits
The same service costs 5.9 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· 48th of 51
$525
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.