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 $1,584.89 Median $1,698.24 Typical High $1,778.28 | Professional | None | $1,584.89 | $1,698.24 | $1,778.28 |
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 $1,698.24 Median $2,754.23 Typical High $3,548.13 | Professional | None | $1,698.24 | $2,754.23 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,737.80 | $2,691.53 | $2,691.53 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,778.28 | $1,905.46 | $2,884.03 |
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 $912.01 Median $1,202.26 Typical High $2,691.53 | Professional | None | $912.01 | $1,202.26 | $2,691.53 |
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 $851.14 Typical High $870.96 | Professional | 52 · Reduced service | $776.25 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $338.84 Typical High $354.81 | Professional | 53 · Discontinued | $316.23 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,258.93 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,174.90 | $1,258.93 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $251.19 Typical High $263.03 | Professional | 55 · Aftercare only | $234.42 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $169.82 Typical High $177.83 | Professional | 56 · Pre-op care only | $158.49 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,174.90 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,174.90 | $1,230.27 |
Where New Jersey sits
The same service costs 6.0 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
$1,778
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.