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 $2,290.87 Median $2,290.87 Typical High $4,265.80 | Professional | None | $2,290.87 | $2,290.87 | $4,265.80 |
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 $2,290.87 Median $3,715.35 Typical High $8,128.31 | Professional | None | $2,290.87 | $3,715.35 | $8,128.31 |
Emblem Health Setting Professional Modifier None Typical Low $2,570.40 Median $3,548.13 Typical High $3,715.35 | Professional | None | $2,570.40 | $3,548.13 | $3,715.35 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $2,570.40 Typical High $7,585.78 | Professional | None | $2,398.83 | $2,570.40 | $7,585.78 |
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 $2,041.74 Median $2,691.53 Typical High $11,481.54 | Professional | None | $2,041.74 | $2,691.53 | $11,481.54 |
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 $1,148.15 Median $1,148.15 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $512.86 | Professional | 53 · Discontinued | $457.09 | $457.09 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $257.04 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,819.70 |
Where New Jersey sits
The same service costs 7.6 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· 37th of 51
$2,570
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.