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 $309.03 Median $4,677.35 Typical High $11,748.98 | Facility | None | $309.03 | $4,677.35 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $707.95 | Professional | None | $331.13 | $389.05 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $4,168.69 | Facility | None | $1,148.15 | $2,754.23 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $851.14 | Professional | None | $416.87 | $512.86 | $851.14 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $691.83 | Professional | None | $478.63 | $691.83 | $691.83 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $12,302.69 | Facility | None | $2,691.53 | $4,786.30 | $12,302.69 |
Horizon BCBS Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $1,230.27 | Professional | None | $363.08 | $467.74 | $1,230.27 |
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 $309.03 Median $398.11 Typical High $776.25 | Professional | None | $309.03 | $398.11 | $776.25 |
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 $154.88 Median $177.83 Typical High $213.80 | Professional | 52 · Reduced service | $154.88 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $72.44 Typical High $85.11 | Professional | 53 · Discontinued | $61.66 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $229.09 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $53.70 Typical High $64.57 | Professional | 55 · Aftercare only | $45.71 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $35.48 Typical High $42.66 | Professional | 56 · Pre-op care only | $30.90 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $251.19 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $213.80 | $251.19 | $302.00 |
Where New Jersey sits
The same service costs 4.3 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
$468
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.