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 $2,344.23 Median $4,570.88 Typical High $11,748.98 | Facility | None | $2,344.23 | $4,570.88 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,570.40 | Professional | None | $2,344.23 | $2,344.23 | $2,570.40 |
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 $2,398.83 Median $3,981.07 Typical High $8,317.64 | Professional | None | $2,398.83 | $3,981.07 | $8,317.64 |
Emblem Health Setting Professional Modifier None Typical Low $2,818.38 Median $3,801.89 Typical High $4,073.80 | Professional | None | $2,818.38 | $3,801.89 | $4,073.80 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $8,128.31 | Professional | None | $2,570.40 | $2,818.38 | $8,128.31 |
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 $2,187.76 Median $2,884.03 Typical High $12,302.69 | Professional | None | $2,187.76 | $2,884.03 | $12,302.69 |
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 $1,174.90 Median $1,174.90 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $501.19 | Professional | 53 · Discontinued | $467.74 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $251.19 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,778.28 |
Where New Jersey sits
The same service costs 10.0 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· 38th of 51
$2,692
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.