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 $2,238.72 Median $2,238.72 Typical High $2,884.03 | Professional | None | $2,238.72 | $2,238.72 | $2,884.03 |
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 $2,238.72 Median $3,630.78 Typical High $7,943.28 | Professional | None | $2,238.72 | $3,630.78 | $7,943.28 |
Emblem Health Setting Professional Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $3,630.78 | Professional | None | $2,511.89 | $3,467.37 | $3,630.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,344.23 Median $2,511.89 Typical High $7,413.10 | Professional | None | $2,344.23 | $2,511.89 | $7,413.10 |
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 $1,995.26 Median $2,630.27 Typical High $11,220.18 | Professional | None | $1,995.26 | $2,630.27 | $11,220.18 |
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 $1,122.02 Median $1,122.02 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 53 · Discontinued | $446.68 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,737.80 |
Where New Jersey sits
The same service costs 14.5 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
$2,512
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.