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 $7,244.36 Typical High $11,748.98 | Facility | None | $4,466.84 | $7,244.36 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $691.83 | Professional | None | $588.84 | $588.84 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $3,981.07 | Facility | None | $1,318.26 | $2,754.23 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $977.24 | Professional | None | $489.78 | $524.81 | $977.24 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $891.25 | Professional | None | $676.08 | $891.25 | $891.25 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $15,848.93 | Facility | None | $2,630.27 | $4,677.35 | $15,848.93 |
Horizon BCBS Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $954.99 | Professional | None | $630.96 | $724.44 | $954.99 |
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 $426.58 Median $549.54 Typical High $724.44 | Professional | None | $426.58 | $549.54 | $724.44 |
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 $295.12 Median $295.12 Typical High $338.84 | Professional | 52 · Reduced service | $295.12 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | 53 · Discontinued | $117.49 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | 54 · Surgery only | $446.68 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $67.61 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $467.74 |
Where New Jersey sits
The same service costs 8.5 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
$631
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.