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 $676.08 Median $676.08 Typical High $831.76 | Professional | None | $676.08 | $676.08 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,238.72 Typical High $4,570.88 | Facility | None | $1,318.26 | $2,238.72 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $1,122.02 | Professional | None | $575.44 | $616.60 | $1,122.02 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $1,071.52 | Professional | None | $446.68 | $660.69 | $1,071.52 |
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 $676.08 Median $776.25 Typical High $1,096.48 | Professional | None | $676.08 | $776.25 | $1,096.48 |
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 $501.19 Median $630.96 Typical High $794.33 | Professional | None | $501.19 | $630.96 | $794.33 |
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 $338.84 Median $338.84 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 53 · Discontinued | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $602.56 | Professional | 54 · Surgery only | $501.19 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $79.43 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $562.34 |
Where New Jersey sits
The same service costs 4.6 times more in Alaska than in New York. 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· 50th of 51
$692
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.