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 $676.08 Median $6,309.57 Typical High $10,964.78 | Facility | None | $676.08 | $6,309.57 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $1,174.90 | Professional | None | $512.86 | $602.56 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,311.31 Typical High $6,025.60 | Facility | None | $1,174.90 | $3,311.31 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,698.24 | Professional | None | $549.54 | $645.65 | $1,698.24 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $912.01 | Professional | None | $616.60 | $912.01 | $912.01 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $7,585.78 Typical High $19,952.62 | Facility | None | $4,265.80 | $7,585.78 | $19,952.62 |
Horizon BCBS Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,698.24 | Professional | None | $602.56 | $724.44 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,918.31 | Facility | None | $1,122.02 | $2,884.03 | $6,918.31 |
United Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $1,548.82 | Professional | None | $426.58 | $602.56 | $1,548.82 |
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 $257.04 Median $257.04 Typical High $389.05 | Professional | 52 · Reduced service | $257.04 | $257.04 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $154.88 | Professional | 53 · Discontinued | $102.33 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $575.44 | Professional | 54 · Surgery only | $389.05 | $389.05 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $114.82 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $77.62 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $537.03 |
Where New Jersey sits
The same service costs 5.4 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· 37th of 51
$794
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.