How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $79.43 Median $269.15 Typical High $7,244.36 | Facility | None | $79.43 | $269.15 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $269.15 | Professional | None | $79.43 | $81.28 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $446.68 Typical High $1,412.54 | Facility | None | $295.12 | $446.68 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $213.80 Typical High $436.52 | Professional | None | $104.71 | $213.80 | $436.52 |
United Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,698.24 | Facility | None | $229.09 | $398.11 | $1,698.24 |
United Setting Professional Modifier None Typical Low $85.11 Median $245.47 Typical High $446.68 | Professional | None | $85.11 | $245.47 | $446.68 |
5 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 $39.81 Median $40.74 Typical High $134.90 | Professional | 52 · Reduced service | $39.81 | $40.74 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.60 Typical High $53.70 | Professional | 53 · Discontinued | $15.85 | $16.60 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $61.66 Typical High $204.17 | Professional | 54 · Surgery only | $58.88 | $61.66 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.30 Typical High $40.74 | Professional | 55 · Aftercare only | $11.75 | $12.30 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.13 Typical High $26.92 | Professional | 56 · Pre-op care only | $7.94 | $8.13 | $26.92 |
Where Delaware sits
The same service costs 4.3 times more in Oklahoma than in Nebraska. 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.
Delaware· 42nd of 51
$269
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.