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 $549.54 Median $549.54 Typical High $676.08 | Professional | None | $549.54 | $549.54 | $676.08 |
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 $467.74 Median $501.19 Typical High $954.99 | Professional | None | $467.74 | $501.19 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $851.14 | Professional | None | $645.65 | $851.14 | $851.14 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $2,884.03 Typical High $8,912.51 | Facility | None | $1,584.89 | $2,884.03 | $8,912.51 |
Horizon BCBS Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $933.25 | Professional | None | $602.56 | $707.95 | $933.25 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,548.82 Typical High $4,168.69 | Facility | None | $537.03 | $1,548.82 | $4,168.69 |
United Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $758.58 | Professional | None | $407.38 | $537.03 | $758.58 |
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 $269.15 Median $269.15 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $489.78 | Professional | 54 · Surgery only | $407.38 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $457.09 |
Where New Jersey sits
The same service costs 7.6 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· 42nd of 51
$603
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.