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 $4,466.84 Median $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $1,148.15 | Professional | None | $870.96 | $891.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,023.29 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $2,238.72 | Professional | None | $812.83 | $954.99 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,258.93 | Professional | None | $912.01 | $1,258.93 | $1,258.93 |
Horizon BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $2,344.23 | Professional | None | $870.96 | $1,023.29 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,318.26 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $2,041.74 | Professional | None | $794.33 | $1,047.13 | $2,041.74 |
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 $436.52 Median $446.68 Typical High $524.81 | Professional | 52 · Reduced service | $436.52 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $177.83 Typical High $213.80 | Professional | 53 · Discontinued | $173.78 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $676.08 Typical High $794.33 | Professional | 54 · Surgery only | $645.65 | $676.08 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $134.90 Typical High $158.49 | Professional | 55 · Aftercare only | $128.82 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $89.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $87.10 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $630.96 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $602.56 | $630.96 | $741.31 |
Where New Jersey sits
The same service costs 6.5 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· 39th of 51
$1,072
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.