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 $2,754.23 Median $7,079.46 Typical High $11,748.98 | Facility | None | $2,754.23 | $7,079.46 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $954.99 | Professional | None | $407.38 | $512.86 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $3,388.44 | Facility | None | $1,000.00 | $1,995.26 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $724.44 | Professional | None | $346.74 | $457.09 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $912.01 | Professional | None | $676.08 | $912.01 | $912.01 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,584.89 | $2,951.21 | $8,912.51 |
Horizon BCBS Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $912.01 | Professional | None | $426.58 | $630.96 | $912.01 |
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 $309.03 Median $426.58 Typical High $588.84 | Professional | None | $309.03 | $426.58 | $588.84 |
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 $204.17 Median $257.04 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $102.33 Typical High $104.71 | Professional | 53 · Discontinued | $81.28 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $380.19 Typical High $389.05 | Professional | 54 · Surgery only | $309.03 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $75.86 Typical High $77.62 | Professional | 55 · Aftercare only | $61.66 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $51.29 Typical High $52.48 | Professional | 56 · Pre-op care only | $40.74 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $354.81 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $288.40 | $354.81 | $363.08 |
Where New Jersey sits
The same service costs 6.5 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
$501
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.