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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $512.86 | Professional | None | $323.59 | $323.59 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $3,801.89 | Facility | None | $933.25 | $2,290.87 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $1,096.48 | Professional | None | $354.81 | $426.58 | $1,096.48 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $588.84 | Professional | None | $398.11 | $588.84 | $588.84 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $2,630.27 | $5,011.87 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $1,096.48 | Professional | None | $380.19 | $446.68 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $954.99 | Professional | None | $269.15 | $380.19 | $954.99 |
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 $162.18 Median $162.18 Typical High $245.47 | Professional | 52 · Reduced service | $162.18 | $162.18 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $100.00 | Professional | 53 · Discontinued | $64.57 | $64.57 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $245.47 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $74.13 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $50.12 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $346.74 |
Where New Jersey sits
The same service costs 6.2 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
$513
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.