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 $1,000.00 Median $1,000.00 Typical High $1,122.02 | Professional | None | $1,000.00 | $1,000.00 | $1,122.02 |
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 $758.58 Median $912.01 Typical High $1,819.70 | Professional | None | $758.58 | $912.01 | $1,819.70 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,659.59 | $1,862.09 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,288.25 | $1,698.24 |
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 $660.69 Median $812.83 Typical High $1,230.27 | Professional | None | $660.69 | $812.83 | $1,230.27 |
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 $501.19 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $501.19 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $229.09 | Professional | 53 · Discontinued | $199.53 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $758.58 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $794.33 |
Where New Jersey sits
The same service costs 5.6 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
$1,000
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.