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 $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,202.26 | Professional | None | $776.25 | $776.25 | $1,202.26 |
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 $831.76 Median $1,023.29 Typical High $2,570.40 | Professional | None | $831.76 | $1,023.29 | $2,570.40 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,348.96 | Professional | None | $954.99 | $1,348.96 | $1,348.96 |
Horizon BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $2,511.89 | Professional | None | $912.01 | $1,071.52 | $2,511.89 |
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 $645.65 Median $912.01 Typical High $2,290.87 | Professional | None | $645.65 | $912.01 | $2,290.87 |
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 $389.05 Median $389.05 Typical High $588.84 | Professional | 52 · Reduced service | $389.05 | $389.05 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $239.88 | Professional | 53 · Discontinued | $154.88 | $154.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $891.25 | Professional | 54 · Surgery only | $575.44 | $575.44 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $177.83 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $117.49 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $831.76 |
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· 41st of 51
$1,023
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.