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 $933.25 Median $933.25 Typical High $1,230.27 | Professional | None | $933.25 | $933.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,778.28 Typical High $2,691.53 | Facility | None | $1,000.00 | $1,778.28 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,949.84 Typical High $2,238.72 | Professional | None | $1,174.90 | $1,949.84 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,445.44 | $1,905.46 | $1,905.46 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $2,884.03 Typical High $7,413.10 | Facility | None | $1,584.89 | $2,884.03 | $7,413.10 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,318.26 | $1,778.28 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,905.46 | Professional | None | $660.69 | $851.14 | $1,905.46 |
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 $467.74 Median $467.74 Typical High $616.60 | Professional | 52 · Reduced service | $467.74 | $467.74 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $245.47 | Professional | 53 · Discontinued | $186.21 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $912.01 | Professional | 54 · Surgery only | $691.83 | $691.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $181.97 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $123.03 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $851.14 |
Where New Jersey sits
The same service costs 5.8 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· 41st of 51
$1,230
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.