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 $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,047.13 | Professional | None | $645.65 | $776.25 | $1,047.13 |
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 $724.44 Median $870.96 Typical High $2,238.72 | Professional | None | $724.44 | $870.96 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $1,202.26 | Professional | None | $812.83 | $1,202.26 | $1,202.26 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $7,585.78 Typical High $19,952.62 | Facility | None | $4,168.69 | $7,585.78 | $19,952.62 |
Horizon BCBS Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $2,238.72 | Professional | None | $812.83 | $954.99 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $2,041.74 | Professional | None | $575.44 | $812.83 | $2,041.74 |
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 $323.59 Median $323.59 Typical High $524.81 | Professional | 52 · Reduced service | $323.59 | $323.59 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $208.93 | Professional | 53 · Discontinued | $128.82 | $128.82 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $776.25 | Professional | 54 · Surgery only | $489.78 | $489.78 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $154.88 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $104.71 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $724.44 |
Where New Jersey sits
The same service costs 5.9 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· 39th of 51
$1,047
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.