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 $1,096.48 Median $1,096.48 Typical High $1,174.90 | Professional | None | $1,096.48 | $1,096.48 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $7,585.78 Typical High $14,791.08 | Facility | None | $933.25 | $7,585.78 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,698.24 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,513.56 | $1,513.56 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $7,762.47 Typical High $35,481.34 | Facility | None | $4,168.69 | $7,762.47 | $35,481.34 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,202.26 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,168.69 | $9,772.37 |
United Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $1,584.89 | Professional | None | $512.86 | $676.08 | $1,584.89 |
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 $537.03 Median $537.03 Typical High $549.54 | Professional | 52 · Reduced service | $537.03 | $537.03 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $223.87 | Professional | 53 · Discontinued | $218.78 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $831.76 | Professional | 54 · Surgery only | $812.83 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $165.96 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $776.25 |
Where New Jersey sits
The same service costs 6.2 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· 40th of 51
$1,122
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.