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 $2,754.23 Median $5,754.40 Typical High $10,471.29 | Facility | None | $2,754.23 | $5,754.40 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $512.86 | Professional | None | $275.42 | $354.81 | $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 $245.47 Median $380.19 Typical High $954.99 | Professional | None | $245.47 | $380.19 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $645.65 | Professional | None | $426.58 | $645.65 | $645.65 |
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 $269.15 Median $478.63 Typical High $1,174.90 | Professional | None | $269.15 | $478.63 | $1,174.90 |
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 $190.55 Median $323.59 Typical High $870.96 | Professional | None | $190.55 | $323.59 | $870.96 |
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 $138.04 Median $173.78 Typical High $257.04 | Professional | 52 · Reduced service | $138.04 | $173.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $69.18 Typical High $102.33 | Professional | 53 · Discontinued | $56.23 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $257.04 Typical High $380.19 | Professional | 54 · Surgery only | $208.93 | $257.04 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $52.48 Typical High $75.86 | Professional | 55 · Aftercare only | $41.69 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $34.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $27.54 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $239.88 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $194.98 | $239.88 | $354.81 |
Where New Jersey sits
The same service costs 4.8 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· 31st of 51
$479
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.