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 $8,912.51 Typical High $13,803.84 | Facility | None | $4,466.84 | $8,912.51 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,412.54 | Professional | None | $912.01 | $912.01 | $1,412.54 |
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 $1,000.00 Median $1,174.90 Typical High $3,090.30 | Professional | None | $1,000.00 | $1,174.90 | $3,090.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,621.81 | $1,621.81 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $3,019.95 | Professional | None | $1,096.48 | $1,288.25 | $3,019.95 |
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 $776.25 Median $1,096.48 Typical High $2,754.23 | Professional | None | $776.25 | $1,096.48 | $2,754.23 |
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 $457.09 Median $457.09 Typical High $707.95 | Professional | 52 · Reduced service | $457.09 | $457.09 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $281.84 | Professional | 53 · Discontinued | $186.21 | $186.21 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $1,047.13 | Professional | 54 · Surgery only | $691.83 | $691.83 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $208.93 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $141.25 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $977.24 |
Where New Jersey sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 40th of 51
$1,230
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.