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 $707.95 Median $707.95 Typical High $1,071.52 | Professional | None | $707.95 | $707.95 | $1,071.52 |
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 $776.25 Median $912.01 Typical High $2,454.71 | Professional | None | $776.25 | $912.01 | $2,454.71 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,258.93 | Professional | None | $851.14 | $1,258.93 | $1,258.93 |
Horizon BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $2,344.23 | Professional | None | $851.14 | $1,000.00 | $2,344.23 |
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 $588.84 Median $851.14 Typical High $2,137.96 | Professional | None | $588.84 | $851.14 | $2,137.96 |
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 $354.81 Median $354.81 Typical High $537.03 | Professional | 52 · Reduced service | $354.81 | $354.81 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $213.80 | Professional | 53 · Discontinued | $141.25 | $141.25 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $812.83 | Professional | 54 · Surgery only | $537.03 | $537.03 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $162.18 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $107.15 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $758.58 |
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· 42nd of 51
$955
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.