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 $1,513.56 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,513.56 | $1,513.56 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $3,715.35 Typical High $6,456.54 | Facility | None | $2,290.87 | $3,715.35 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,630.27 Typical High $5,370.32 | Professional | None | $1,584.89 | $2,630.27 | $5,370.32 |
Emblem Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,511.89 | $2,630.27 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $8,128.31 Typical High $13,803.84 | Facility | None | $4,897.79 | $8,128.31 | $13,803.84 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $5,248.07 | Professional | None | $1,698.24 | $1,819.70 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,073.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $7,943.28 | Professional | None | $1,412.54 | $1,905.46 | $7,943.28 |
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 $758.58 Median $758.58 Typical High $912.01 | Professional | 52 · Reduced service | $758.58 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $363.08 | Professional | 53 · Discontinued | $302.00 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $275.42 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $181.97 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,288.25 |
Where New Jersey sits
The same service costs 6.6 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· 29th of 51
$2,188
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.