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 $234.42 Typical High $7,244.36 | Facility | None | $158.49 | $234.42 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $380.19 | Professional | None | $158.49 | $234.42 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,479.11 | Facility | None | $562.34 | $1,000.00 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $338.84 | Professional | None | $173.78 | $269.15 | $338.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $8,511.38 | Facility | None | $602.56 | $1,380.38 | $8,511.38 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $346.74 | Professional | None | $154.88 | $223.87 | $346.74 |
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 $93.33 Typical High $123.03 | Professional | 52 · Reduced service | $79.43 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $37.15 Typical High $48.98 | Professional | 53 · Discontinued | $32.36 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $138.04 Typical High $181.97 | Professional | 54 · Surgery only | $120.23 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $27.54 Typical High $36.31 | Professional | 55 · Aftercare only | $23.99 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.62 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.85 | $18.62 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $128.82 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $112.20 | $128.82 | $169.82 |
Where Delaware sits
The same service costs 4.2 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.
Delaware· 42nd of 51
$251
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.