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 $851.14 Median $933.25 Typical High $1,023.29 | Professional | None | $851.14 | $933.25 | $1,023.29 |
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 $977.24 Median $1,513.56 Typical High $3,311.31 | Professional | None | $977.24 | $1,513.56 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,584.89 | $1,659.59 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $3,235.94 | Professional | None | $1,023.29 | $1,122.02 | $3,235.94 |
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 $851.14 Median $1,148.15 Typical High $4,897.79 | Professional | None | $851.14 | $1,148.15 | $4,897.79 |
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 $416.87 Median $457.09 Typical High $478.63 | Professional | 52 · Reduced service | $416.87 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $186.21 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $691.83 Typical High $724.44 | Professional | 54 · Surgery only | $630.96 | $691.83 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $144.54 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $676.08 |
Where New Jersey sits
The same service costs 7.4 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· 36th of 51
$1,122
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.