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 $758.58 Median $6,918.31 Typical High $11,748.98 | Facility | None | $758.58 | $6,918.31 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | None | $707.95 | $707.95 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $3,981.07 | Facility | None | $1,318.26 | $2,754.23 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,862.09 | Professional | None | $602.56 | $724.44 | $1,862.09 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,000.00 | Professional | None | $676.08 | $1,000.00 | $1,000.00 |
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 $676.08 Median $794.33 Typical High $1,949.84 | Professional | None | $676.08 | $794.33 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $1,659.59 | Professional | None | $436.52 | $616.60 | $1,659.59 |
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 $354.81 Median $354.81 Typical High $416.87 | Professional | 52 · Reduced service | $354.81 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $83.18 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $575.44 |
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· 41st of 51
$832
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.