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 $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,318.26 | $1,318.26 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $4,786.30 Typical High $9,332.54 | Facility | None | $1,174.90 | $4,786.30 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $2,137.96 Typical High $2,818.38 | Professional | None | $1,288.25 | $2,137.96 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,412.54 | $1,905.46 | $1,905.46 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $8,912.51 Typical High $33,113.11 | Facility | None | $4,897.79 | $8,912.51 | $33,113.11 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,513.56 | $2,187.76 |
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 $645.65 Median $851.14 Typical High $1,995.26 | Professional | None | $645.65 | $851.14 | $1,995.26 |
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 $660.69 Median $660.69 Typical High $691.83 | Professional | 52 · Reduced service | $660.69 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $275.42 | Professional | 53 · Discontinued | $263.03 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $977.24 |
Where New Jersey sits
The same service costs 11.0 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
$1,413
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.