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 $630.96 Median $630.96 Typical High $954.99 | Professional | None | $630.96 | $630.96 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $3,801.89 | Facility | None | $1,698.24 | $2,570.40 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $2,089.30 | Professional | None | $691.83 | $851.14 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,122.02 | Professional | None | $758.58 | $1,122.02 | $1,122.02 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $5,011.87 Typical High $13,182.57 | Facility | None | $2,754.23 | $5,011.87 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $2,041.74 | Professional | None | $741.31 | $891.25 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,818.38 | $6,760.83 |
United Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,905.46 | Professional | None | $537.03 | $741.31 | $1,905.46 |
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 $316.23 Median $316.23 Typical High $478.63 | Professional | 52 · Reduced service | $316.23 | $316.23 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $190.55 | Professional | 53 · Discontinued | $125.89 | $125.89 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $707.95 | Professional | 54 · Surgery only | $467.74 | $467.74 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $141.25 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $660.69 |
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· 39th of 51
$933
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.