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 $2,570.40 Median $2,570.40 Typical High $3,388.44 | Professional | None | $2,570.40 | $2,570.40 | $3,388.44 |
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 $2,570.40 Median $4,265.80 Typical High $9,120.11 | Professional | None | $2,570.40 | $4,265.80 | $9,120.11 |
Emblem Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,981.07 Typical High $4,265.80 | Professional | None | $2,951.21 | $3,981.07 | $4,265.80 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $2,951.21 Typical High $8,709.64 | Professional | None | $2,754.23 | $2,951.21 | $8,709.64 |
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 $2,238.72 Median $3,090.30 Typical High $13,182.57 | Professional | None | $2,238.72 | $3,090.30 | $13,182.57 |
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 $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | 53 · Discontinued | $512.86 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $295.12 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $2,089.30 |
Where New Jersey sits
The same service costs 17.0 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
$2,818
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.