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 $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $891.25 | Professional | None | $724.44 | $812.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $977.24 Typical High $2,691.53 | Facility | None | $562.34 | $977.24 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,548.82 Typical High $1,819.70 | Professional | None | $933.25 | $1,548.82 | $1,819.70 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,513.56 | $1,513.56 |
Horizon BCBS Setting Facility Modifier None Typical Low $831.76 Median $1,479.11 Typical High $3,630.78 | Facility | None | $831.76 | $1,479.11 | $3,630.78 |
Horizon BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,412.54 | Professional | None | $977.24 | $1,071.52 | $1,412.54 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,584.89 Typical High $3,981.07 | Facility | None | $537.03 | $1,584.89 | $3,981.07 |
United Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,513.56 | Professional | None | $524.81 | $676.08 | $1,513.56 |
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 $363.08 Median $407.38 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $630.96 |
Where New Jersey sits
The same service costs 22.4 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· 35th of 51
$1,000
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.