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 $977.24 Median $977.24 Typical High $1,174.90 | Professional | None | $977.24 | $977.24 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $3,019.95 | Facility | None | $1,047.13 | $2,089.30 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,584.89 | Professional | None | $831.76 | $891.25 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,479.11 | $1,479.11 |
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 $1,047.13 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,202.26 | $1,621.81 |
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 $707.95 Median $891.25 Typical High $1,230.27 | Professional | None | $707.95 | $891.25 | $1,230.27 |
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 $489.78 Median $489.78 Typical High $575.44 | Professional | 52 · Reduced service | $489.78 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | 53 · Discontinued | $194.98 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $851.14 | Professional | 54 · Surgery only | $724.44 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $169.82 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $114.82 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $794.33 |
Where New Jersey sits
The same service costs 7.6 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
$1,047
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.