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 $6,918.31 Typical High $12,882.50 | Facility | None | $4,365.16 | $6,918.31 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,778.28 | $1,778.28 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,071.52 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $4,677.35 | Professional | None | $1,513.56 | $1,819.70 | $4,677.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,778.28 | $2,454.71 | $2,454.71 |
Horizon BCBS Setting Facility Modifier None Typical Low $17,378.01 Median $23,988.33 Typical High $30,199.52 | Facility | None | $17,378.01 | $23,988.33 | $30,199.52 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $4,897.79 | Professional | None | $1,698.24 | $1,995.26 | $4,897.79 |
United Setting Facility Modifier None Typical Low $331.13 Median $1,479.11 Typical High $5,495.41 | Facility | None | $331.13 | $1,479.11 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,548.82 Typical High $4,073.80 | Professional | None | $1,047.13 | $1,548.82 | $4,073.80 |
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 $891.25 Median $891.25 Typical High $1,047.13 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | 53 · Discontinued | $354.81 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $316.23 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,445.44 |
Where New Jersey sits
The same service costs 5.9 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· 43rd of 51
$1,778
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.