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 $478.63 Median $478.63 Typical High $537.03 | Professional | None | $478.63 | $478.63 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,754.23 Typical High $4,168.69 | Facility | None | $1,445.44 | $2,754.23 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $758.58 | Professional | None | $380.19 | $407.38 | $758.58 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $691.83 | Professional | None | $512.86 | $691.83 | $691.83 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,786.30 Typical High $14,791.08 | Facility | None | $2,630.27 | $4,786.30 | $14,791.08 |
Horizon BCBS Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $741.31 | Professional | None | $489.78 | $562.34 | $741.31 |
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 $323.59 Median $426.58 Typical High $575.44 | Professional | None | $323.59 | $426.58 | $575.44 |
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 $234.42 Median $239.88 Typical High $263.03 | Professional | 52 · Reduced service | $234.42 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $95.50 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $398.11 | Professional | 54 · Surgery only | $354.81 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $338.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $331.13 | $338.84 | $371.54 |
Where New Jersey sits
The same service costs 7.9 times more in Wyoming 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· 46th of 51
$490
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.