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 $1,122.02 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,122.02 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $3,235.94 Typical High $4,897.79 | Facility | None | $1,513.56 | $3,235.94 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,122.02 | $1,819.70 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,445.44 | $1,905.46 | $1,905.46 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $14,791.08 | Facility | None | $2,630.27 | $4,677.35 | $14,791.08 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,445.44 | $2,041.74 |
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 $912.01 Median $1,047.13 Typical High $1,445.44 | Professional | None | $912.01 | $1,047.13 | $1,445.44 |
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 $562.34 Median $562.34 Typical High $707.95 | Professional | 52 · Reduced service | $562.34 | $562.34 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $288.40 | Professional | 53 · Discontinued | $223.87 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $1,071.52 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $213.80 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $1,000.00 |
Where New Jersey sits
The same service costs 7.1 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· 44th of 51
$1,259
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.