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 $758.58 Median $758.58 Typical High $1,318.26 | Professional | None | $758.58 | $758.58 | $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 $977.24 Median $1,230.27 Typical High $2,951.21 | Professional | None | $977.24 | $1,230.27 | $2,951.21 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,621.81 | $1,659.59 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,230.27 | $2,884.03 |
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 $741.31 Median $1,047.13 Typical High $2,630.27 | Professional | None | $741.31 | $1,047.13 | $2,630.27 |
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 $380.19 Median $380.19 Typical High $660.69 | Professional | 52 · Reduced service | $380.19 | $380.19 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $263.03 | Professional | 53 · Discontinued | $151.36 | $151.36 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $977.24 | Professional | 54 · Surgery only | $575.44 | $575.44 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $194.98 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $131.83 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $912.01 |
Where New Jersey sits
The same service costs 6.6 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· 37th of 51
$1,175
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.