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 $851.14 Median $851.14 Typical High $1,318.26 | Professional | None | $851.14 | $851.14 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $3,311.31 | Facility | None | $1,548.82 | $2,344.23 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $3,467.37 | Professional | None | $1,023.29 | $1,659.59 | $3,467.37 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,659.59 | $1,737.80 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,398.83 Median $4,466.84 Typical High $13,489.63 | Facility | None | $2,398.83 | $4,466.84 | $13,489.63 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $3,388.44 | Professional | None | $1,071.52 | $1,148.15 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $5,128.61 | Professional | None | $870.96 | $1,202.26 | $5,128.61 |
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 $426.58 Median $426.58 Typical High $588.84 | Professional | 52 · Reduced service | $426.58 | $426.58 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $234.42 | Professional | 53 · Discontinued | $169.82 | $169.82 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | 54 · Surgery only | $645.65 | $645.65 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $812.83 |
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· 28th of 51
$1,445
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.