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 $2,187.76 Median $2,187.76 Typical High $2,754.23 | Professional | None | $2,187.76 | $2,187.76 | $2,754.23 |
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 $2,137.96 Median $3,548.13 Typical High $7,762.47 | Professional | None | $2,137.96 | $3,548.13 | $7,762.47 |
Emblem Health Setting Professional Modifier None Typical Low $2,454.71 Median $3,388.44 Typical High $3,548.13 | Professional | None | $2,454.71 | $3,388.44 | $3,548.13 |
Horizon BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $2,454.71 Typical High $7,079.46 | Professional | None | $2,238.72 | $2,454.71 | $7,079.46 |
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 $1,949.84 Median $2,511.89 Typical High $10,715.19 | Professional | None | $1,949.84 | $2,511.89 | $10,715.19 |
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 $1,071.52 Median $1,071.52 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $489.78 | Professional | 53 · Discontinued | $436.52 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $363.08 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $245.47 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $1,698.24 |
Where New Jersey sits
The same service costs 7.2 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
$2,455
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.