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 $724.44 Median $870.96 Typical High $1,122.02 | Professional | None | $724.44 | $870.96 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,023.29 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,778.28 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,737.80 | $1,737.80 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,230.27 | $1,621.81 |
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 $602.56 Median $776.25 Typical High $1,737.80 | Professional | None | $602.56 | $776.25 | $1,737.80 |
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 $436.52 Typical High $562.34 | Professional | 52 · Reduced service | $363.08 | $436.52 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $173.78 Typical High $223.87 | Professional | 53 · Discontinued | $144.54 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $645.65 Typical High $851.14 | Professional | 54 · Surgery only | $537.03 | $645.65 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $169.82 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $87.10 Typical High $112.20 | Professional | 56 · Pre-op care only | $72.44 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $602.56 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $501.19 | $602.56 | $794.33 |
Where New Jersey sits
The same service costs 21.9 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· 35th of 51
$1,148
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.