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 $7,244.36 Typical High $11,748.98 | Facility | None | $4,466.84 | $7,244.36 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,128.61 | Professional | None | $4,365.16 | $4,365.16 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $3,019.95 | Facility | None | $1,023.29 | $2,137.96 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $3,890.45 Typical High $7,762.47 | Professional | None | $3,235.94 | $3,890.45 | $7,762.47 |
Emblem Health Setting Professional Modifier None Typical Low $5,011.87 Median $7,079.46 Typical High $7,943.28 | Professional | None | $5,011.87 | $7,079.46 | $7,943.28 |
Horizon BCBS Setting Professional Modifier None Typical Low $4,677.35 Median $5,623.41 Typical High $7,413.10 | Professional | None | $4,677.35 | $5,623.41 | $7,413.10 |
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 $2,754.23 Median $3,388.44 Typical High $5,248.07 | Professional | None | $2,754.23 | $3,388.44 | $5,248.07 |
7 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 $2,187.76 Median $2,187.76 Typical High $2,454.71 | Professional | 52 · Reduced service | $2,187.76 | $2,187.76 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $870.96 Typical High $977.24 | Professional | 53 · Discontinued | $870.96 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,311.31 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,311.31 | $3,311.31 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $660.69 Typical High $741.31 | Professional | 55 · Aftercare only | $660.69 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $436.52 Typical High $489.78 | Professional | 56 · Pre-op care only | $436.52 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,090.30 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,090.30 | $3,467.37 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | 58 · Staged procedure | $6,025.60 | $6,025.60 | $6,025.60 |
Where New Jersey sits
The same service costs 20.0 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· 44th of 51
$4,365
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.