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 $630.96 Median $630.96 Typical High $724.44 | Professional | None | $630.96 | $630.96 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,258.93 Typical High $2,691.53 | Facility | None | $691.83 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $1,584.89 | Professional | None | $467.74 | $724.44 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $954.99 | Professional | None | $645.65 | $954.99 | $954.99 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $1,949.84 Typical High $5,888.44 | Facility | None | $1,047.13 | $1,949.84 | $5,888.44 |
Horizon BCBS Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,862.09 | Professional | None | $630.96 | $758.58 | $1,862.09 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $5,623.41 | Facility | None | $707.95 | $1,995.26 | $5,623.41 |
United Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $1,412.54 | Professional | None | $338.84 | $512.86 | $1,412.54 |
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 $316.23 Median $316.23 Typical High $346.74 | Professional | 52 · Reduced service | $316.23 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $138.04 | Professional | 53 · Discontinued | $128.82 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $512.86 | Professional | 54 · Surgery only | $478.63 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $102.33 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $478.63 |
Where New Jersey sits
The same service costs 5.9 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· 39th of 51
$759
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.