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 $891.25 Median $5,623.41 Typical High $11,748.98 | Facility | None | $891.25 | $5,623.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,230.27 | Professional | None | $891.25 | $1,000.00 | $1,230.27 |
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 $1,148.15 Median $1,819.70 Typical High $4,073.80 | Professional | None | $1,148.15 | $1,819.70 | $4,073.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,949.84 | $2,041.74 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $3,890.45 | Professional | None | $1,230.27 | $1,348.96 | $3,890.45 |
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 $1,000.00 Median $1,380.38 Typical High $5,888.44 | Professional | None | $1,000.00 | $1,380.38 | $5,888.44 |
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 $446.68 Median $501.19 Typical High $575.44 | Professional | 52 · Reduced service | $446.68 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | 53 · Discontinued | $181.97 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $851.14 | Professional | 54 · Surgery only | $676.08 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $173.78 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $114.82 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $691.83 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $630.96 | $691.83 | $794.33 |
Where New Jersey sits
The same service costs 5.6 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
$1,349
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.