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 $4,466.84 Median $8,317.64 Typical High $12,882.50 | Facility | None | $4,466.84 | $8,317.64 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,071.52 | Professional | None | $891.25 | $891.25 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,238.72 Typical High $3,801.89 | Facility | None | $1,148.15 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,445.44 | Professional | None | $758.58 | $812.83 | $1,445.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,380.38 | $1,380.38 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $3,630.78 Typical High $8,709.64 | Facility | None | $2,041.74 | $3,630.78 | $8,709.64 |
Horizon BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,479.11 | Professional | None | $954.99 | $1,096.48 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,122.02 | $2,884.03 | $6,760.83 |
United Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,122.02 | Professional | None | $645.65 | $812.83 | $1,122.02 |
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 $446.68 Median $446.68 Typical High $524.81 | Professional | 52 · Reduced service | $446.68 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | 53 · Discontinued | $177.83 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $776.25 | Professional | 54 · Surgery only | $660.69 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $724.44 |
Where New Jersey sits
The same service costs 7.2 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· 45th of 51
$955
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.