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 $4,365.16 Median $6,760.83 Typical High $11,748.98 | Facility | None | $4,365.16 | $6,760.83 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,071.52 | Professional | None | $851.14 | $851.14 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,862.09 Typical High $2,818.38 | Facility | None | $912.01 | $1,862.09 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,412.54 | Professional | None | $741.31 | $812.83 | $1,412.54 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,380.38 | $1,380.38 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $3,019.95 Typical High $8,912.51 | Facility | None | $1,698.24 | $3,019.95 | $8,912.51 |
Horizon BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,479.11 | Professional | None | $933.25 | $1,071.52 | $1,479.11 |
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 $645.65 Median $812.83 Typical High $1,071.52 | Professional | None | $645.65 | $812.83 | $1,071.52 |
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 $426.58 Median $426.58 Typical High $512.86 | Professional | 52 · Reduced service | $426.58 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $208.93 | Professional | 53 · Discontinued | $169.82 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $776.25 | Professional | 54 · Surgery only | $645.65 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $724.44 |
Where New Jersey sits
The same service costs 7.4 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· 45th of 51
$933
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.