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 $1,288.25 Median $6,918.31 Typical High $12,022.64 | Facility | None | $1,288.25 | $6,918.31 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,288.25 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $3,981.07 Typical High $7,079.46 | Facility | None | $1,995.26 | $3,981.07 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $3,235.94 | Professional | None | $1,148.15 | $1,348.96 | $3,235.94 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,819.70 | $1,819.70 |
Horizon BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $10,471.29 Typical High $28,183.83 | Facility | None | $6,165.95 | $10,471.29 | $28,183.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $3,548.13 | Professional | None | $1,258.93 | $1,479.11 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $3,019.95 | Professional | None | $1,148.15 | $1,513.56 | $3,019.95 |
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 $616.60 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $302.00 | Professional | 53 · Discontinued | $251.19 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $125.89 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $1,071.52 |
Where New Jersey sits
The same service costs 6.9 times more in Alaska than in Texas. 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· 35th of 51
$1,660
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.