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 $46.77 Median $89.13 Typical High $7,244.36 | Facility | None | $46.77 | $89.13 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $89.13 Typical High $162.18 | Professional | None | $46.77 | $89.13 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $85.11 Typical High $125.89 | Facility | None | $58.88 | $85.11 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $186.21 | Professional | None | $66.07 | $102.33 | $186.21 |
Highmark BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Facility | None | $8,912.51 | $8,912.51 | $8,912.51 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $54.95 Median $97.72 Typical High $190.55 | Professional | None | $54.95 | $97.72 | $190.55 |
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 $23.44 Median $30.90 Typical High $44.67 | Professional | 52 · Reduced service | $23.44 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $12.30 Typical High $17.78 | Professional | 53 · Discontinued | $9.33 | $12.30 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $46.77 Typical High $67.61 | Professional | 54 · Surgery only | $35.48 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $9.33 Typical High $13.49 | Professional | 55 · Aftercare only | $7.08 | $9.33 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.17 Typical High $8.91 | Professional | 56 · Pre-op care only | $4.68 | $6.17 | $8.91 |
Where Delaware sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 48th of 51
$95.50
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.