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 $9,332.54 Typical High $14,125.38 | Facility | None | $4,466.84 | $9,332.54 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,148.15 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $10,964.78 Median $39,810.72 Typical High $48,977.88 | Facility | None | $10,964.78 | $39,810.72 | $48,977.88 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,230.27 | $2,398.83 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,445.44 | $1,548.82 |
Horizon BCBS Setting Facility Modifier None Typical Low $9,332.54 Median $16,982.44 Typical High $43,651.58 | Facility | None | $9,332.54 | $16,982.44 | $43,651.58 |
Horizon BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $2,754.23 | Professional | None | $1,023.29 | $1,230.27 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $11,481.54 | Facility | None | $1,621.81 | $4,897.79 | $11,481.54 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $2,818.38 | Professional | None | $851.14 | $1,288.25 | $2,818.38 |
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 $501.19 Median $575.44 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $229.09 Typical High $234.42 | Professional | 53 · Discontinued | $204.17 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $870.96 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $870.96 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $173.78 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $114.82 Typical High $117.49 | Professional | 56 · Pre-op care only | $102.33 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $812.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $812.83 | $831.76 |
Where New Jersey sits
The same service costs 8.9 times more in Oklahoma than in Texas. 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· 32nd of 51
$1,622
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.