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 $158.49 Median $229.09 Typical High $3,235.94 | Facility | None | $158.49 | $229.09 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $363.08 | Professional | None | $158.49 | $186.21 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $223.87 Typical High $588.84 | Facility | None | $141.25 | $223.87 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $295.12 | Professional | None | $169.82 | $218.78 | $295.12 |
Highmark BCBS Setting Facility Modifier None Typical Low $239.88 Median $1,174.90 Typical High $3,981.07 | Facility | None | $239.88 | $1,174.90 | $3,981.07 |
Highmark BCBS Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $213.80 | Professional | None | $165.96 | $213.80 | $213.80 |
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 $141.25 Median $181.97 Typical High $263.03 | Professional | None | $141.25 | $181.97 | $263.03 |
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 $79.43 Median $91.20 Typical High $97.72 | Professional | 52 · Reduced service | $79.43 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $36.31 Typical High $39.81 | Professional | 53 · Discontinued | $32.36 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $138.04 Typical High $147.91 | Professional | 54 · Surgery only | $120.23 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $27.54 Typical High $29.51 | Professional | 55 · Aftercare only | $23.99 | $27.54 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $128.82 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $112.20 | $128.82 | $138.04 |
Where Delaware sits
The same service costs 4.4 times more in Alaska than in Florida. 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· 47th of 51
$191
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.