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 $3,890.45 Median $5,888.44 Typical High $10,964.78 | Facility | None | $3,890.45 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | None | $467.74 | $467.74 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,621.81 Typical High $2,454.71 | Facility | None | $794.33 | $1,621.81 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $977.24 | Professional | None | $467.74 | $758.58 | $977.24 |
Emblem Health Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | None | $537.03 | $691.83 | $691.83 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $2,818.38 Typical High $7,413.10 | Facility | None | $1,513.56 | $2,818.38 | $7,413.10 |
Horizon BCBS Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $758.58 | Professional | None | $501.19 | $537.03 | $758.58 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $707.95 | Professional | None | $234.42 | $309.03 | $707.95 |
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 $234.42 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $95.50 | Professional | 53 · Discontinued | $93.33 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $354.81 | Professional | 54 · Surgery only | $346.74 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $47.86 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $331.13 |
Where New Jersey sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 38th of 51
$501
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.