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 $83.18 Median $134.90 Typical High $3,235.94 | Facility | None | $83.18 | $134.90 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $190.55 | Professional | None | $83.18 | $114.82 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $117.49 Typical High $169.82 | Facility | None | $58.88 | $117.49 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $165.96 | Professional | None | $91.20 | $134.90 | $165.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $630.96 Median $891.25 Typical High $7,943.28 | Facility | None | $630.96 | $891.25 | $7,943.28 |
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 $75.86 Median $109.65 Typical High $162.18 | Professional | None | $75.86 | $109.65 | $162.18 |
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 $41.69 Median $48.98 Typical High $58.88 | Professional | 52 · Reduced service | $41.69 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.50 Typical High $23.44 | Professional | 53 · Discontinued | $16.60 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $72.44 Typical High $89.13 | Professional | 54 · Surgery only | $61.66 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.77 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.32 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $67.61 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $57.54 | $67.61 | $83.18 |
Where Delaware sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 45th of 51
$115
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.