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 $588.84 Median $4,570.88 Typical High $11,748.98 | Facility | None | $588.84 | $4,570.88 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $741.31 | Professional | None | $588.84 | $588.84 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $5,128.61 | Facility | None | $1,905.46 | $3,019.95 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,513.56 | Professional | None | $549.54 | $645.65 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $870.96 | Professional | None | $602.56 | $870.96 | $870.96 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $7,413.10 Typical High $18,620.87 | Facility | None | $4,073.80 | $7,413.10 | $18,620.87 |
Horizon BCBS Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,659.59 | Professional | None | $588.84 | $691.83 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,388.44 | $7,943.28 |
United Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,412.54 | Professional | None | $549.54 | $724.44 | $1,412.54 |
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 $295.12 Median $295.12 Typical High $363.08 | Professional | 52 · Reduced service | $295.12 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $144.54 | Professional | 53 · Discontinued | $117.49 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $446.68 Typical High $537.03 | Professional | 54 · Surgery only | $436.52 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $109.65 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $72.44 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $416.87 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $407.38 | $416.87 | $501.19 |
Where New Jersey sits
The same service costs 6.2 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· 34th of 51
$776
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.