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 $2,754.23 Median $7,079.46 Typical High $11,748.98 | Facility | None | $2,754.23 | $7,079.46 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $1,995.26 Typical High $2,454.71 | Professional | None | $363.08 | $1,995.26 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $4,365.16 Typical High $7,762.47 | Facility | None | $1,995.26 | $4,365.16 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $1,778.28 Typical High $3,311.31 | Professional | None | $346.74 | $1,778.28 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,630.27 | $3,467.37 | $3,467.37 |
Horizon BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $6,760.83 Typical High $15,488.17 | Facility | None | $3,630.78 | $6,760.83 | $15,488.17 |
Horizon BCBS Setting Professional Modifier None Typical Low $426.58 Median $2,570.40 Typical High $3,388.44 | Professional | None | $426.58 | $2,570.40 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $4,073.80 Typical High $9,772.37 | Facility | None | $1,548.82 | $4,073.80 | $9,772.37 |
United Setting Professional Modifier None Typical Low $316.23 Median $1,584.89 Typical High $2,454.71 | Professional | None | $316.23 | $1,584.89 | $2,454.71 |
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 $181.97 Median $338.84 Typical High $1,230.27 | Professional | 52 · Reduced service | $181.97 | $338.84 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $134.90 Typical High $489.78 | Professional | 53 · Discontinued | $72.44 | $134.90 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $501.19 Typical High $1,819.70 | Professional | 54 · Surgery only | $275.42 | $501.19 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $100.00 Typical High $371.54 | Professional | 55 · Aftercare only | $54.95 | $100.00 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $67.61 Typical High $245.47 | Professional | 56 · Pre-op care only | $36.31 | $67.61 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $467.74 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $257.04 | $467.74 | $1,698.24 |
Where New Jersey sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 33rd of 51
$1,820
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.