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 $1,479.11 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,479.11 | $1,479.11 | $1,621.81 |
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 $1,445.44 Median $2,344.23 Typical High $3,090.30 | Professional | None | $1,445.44 | $2,344.23 | $3,090.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,513.56 | $2,041.74 | $2,041.74 |
Horizon BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,912.51 Typical High $33,113.11 | Facility | None | $4,677.35 | $8,912.51 | $33,113.11 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,513.56 | $1,621.81 | $2,398.83 |
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 $691.83 Median $912.01 Typical High $2,187.76 | Professional | None | $691.83 | $912.01 | $2,187.76 |
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 $741.31 Median $741.31 Typical High $812.83 | Professional | 52 · Reduced service | $741.31 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $323.59 | Professional | 53 · Discontinued | $295.12 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $245.47 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $162.18 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,148.15 |
Where New Jersey sits
The same service costs 24.5 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
$1,514
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.