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 $1,548.82 Median $1,548.82 Typical High $1,659.59 | Professional | None | $1,548.82 | $1,548.82 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $5,495.41 Typical High $19,498.45 | Facility | None | $1,737.80 | $5,495.41 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,570.40 Typical High $3,388.44 | Professional | None | $1,584.89 | $2,570.40 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,905.46 | $2,511.89 | $2,511.89 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,659.59 | $1,778.28 | $2,691.53 |
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 $851.14 Median $1,122.02 Typical High $2,511.89 | Professional | None | $851.14 | $1,122.02 | $2,511.89 |
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 $776.25 Median $776.25 Typical High $812.83 | Professional | 52 · Reduced service | $776.25 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $331.13 | Professional | 53 · Discontinued | $309.03 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $245.47 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $165.96 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,148.15 |
Where New Jersey sits
The same service costs 22.9 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· 39th of 51
$1,660
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.