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 $741.31 Median $741.31 Typical High $1,148.15 | Professional | None | $741.31 | $741.31 | $1,148.15 |
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 $812.83 Median $954.99 Typical High $2,454.71 | Professional | None | $812.83 | $954.99 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,318.26 | Professional | None | $891.25 | $1,318.26 | $1,318.26 |
Horizon BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $2,454.71 | Professional | None | $891.25 | $1,047.13 | $2,454.71 |
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 $630.96 Median $891.25 Typical High $2,238.72 | Professional | None | $630.96 | $891.25 | $2,238.72 |
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 $371.54 Median $371.54 Typical High $562.34 | Professional | 52 · Reduced service | $371.54 | $371.54 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $229.09 | Professional | 53 · Discontinued | $151.36 | $151.36 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $851.14 | Professional | 54 · Surgery only | $562.34 | $562.34 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $169.82 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $114.82 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $794.33 |
Where New Jersey sits
The same service costs 5.6 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· 42nd 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.