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 $977.24 Median $977.24 Typical High $1,258.93 | Professional | None | $977.24 | $977.24 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,023.29 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,621.81 Typical High $3,548.13 | Professional | None | $977.24 | $1,621.81 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,584.89 | $1,659.59 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $3,235.94 | Professional | None | $1,023.29 | $1,096.48 | $3,235.94 |
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 $870.96 Median $1,148.15 Typical High $4,786.30 | Professional | None | $870.96 | $1,148.15 | $4,786.30 |
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 $489.78 Median $489.78 Typical High $549.54 | Professional | 52 · Reduced service | $489.78 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $223.87 | Professional | 53 · Discontinued | $194.98 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $831.76 | Professional | 54 · Surgery only | $741.31 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $112.20 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $776.25 |
Where New Jersey sits
The same service costs 6.8 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
$1,122
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.