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 $5,495.41 Typical High $11,748.98 | Facility | None | $2,754.23 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $416.87 | Professional | None | $338.84 | $338.84 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,238.72 Typical High $3,801.89 | Facility | None | $691.83 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $977.24 | Professional | None | $309.03 | $398.11 | $977.24 |
Emblem Health Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $512.86 | Professional | None | $346.74 | $512.86 | $512.86 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $5,011.87 Typical High $13,182.57 | Facility | None | $2,818.38 | $5,011.87 | $13,182.57 |
Horizon BCBS Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $977.24 | Professional | None | $331.13 | $398.11 | $977.24 |
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 $218.78 Median $309.03 Typical High $851.14 | Professional | None | $218.78 | $309.03 | $851.14 |
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 $169.82 Median $169.82 Typical High $208.93 | Professional | 52 · Reduced service | $169.82 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | 53 · Discontinued | $69.18 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $316.23 | Professional | 54 · Surgery only | $257.04 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $63.10 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $295.12 |
Where New Jersey sits
The same service costs 6.9 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· 36th of 51
$457
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.