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 $1,479.11 Median $6,309.57 Typical High $10,471.29 | Facility | None | $1,479.11 | $6,309.57 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,479.11 | $1,479.11 | $2,570.40 |
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 $1,230.27 Median $1,513.56 Typical High $3,715.35 | Professional | None | $1,230.27 | $1,513.56 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,995.26 | $1,995.26 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $7,244.36 Typical High $21,877.62 | Facility | None | $4,168.69 | $7,244.36 | $21,877.62 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $3,890.45 | Professional | None | $1,348.96 | $1,584.89 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $3,311.31 | Professional | None | $851.14 | $1,258.93 | $3,311.31 |
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 $724.44 Median $724.44 Typical High $831.76 | Professional | 52 · Reduced service | $724.44 | $724.44 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $331.13 | Professional | 53 · Discontinued | $295.12 | $295.12 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,174.90 |
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· 40th of 51
$1,660
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.