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 $691.83 Median $691.83 Typical High $891.25 | Professional | None | $691.83 | $691.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,290.87 Typical High $3,801.89 | Facility | None | $933.25 | $2,290.87 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,122.02 | Professional | None | $676.08 | $724.44 | $1,122.02 |
Emblem Health Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | None | $933.25 | $1,258.93 | $1,258.93 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,677.35 Typical High $14,791.08 | Facility | None | $2,511.89 | $4,677.35 | $14,791.08 |
Horizon BCBS Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,318.26 | Professional | None | $776.25 | $912.01 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $912.01 | Professional | None | $602.56 | $676.08 | $912.01 |
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 $346.74 Median $346.74 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $660.69 | Professional | 54 · Surgery only | $512.86 | $512.86 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $131.83 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $616.60 |
Where New Jersey sits
The same service costs 8.3 times more in Wyoming 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· 45th of 51
$776
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.