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 $14.13 Median $15.85 Typical High $7,244.36 | Facility | None | $14.13 | $15.85 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $19.95 | Professional | None | $14.13 | $15.85 | $19.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $7.94 Typical High $8.71 | Professional | 52 · Reduced service | $7.08 | $7.94 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.24 Typical High $3.47 | Professional | 53 · Discontinued | $2.82 | $3.24 | $3.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.72 Median $12.02 Typical High $13.18 | Professional | 54 · Surgery only | $10.72 | $12.02 | $13.18 |
Cigna Setting Facility Modifier None Typical Low $23.44 Median $85.11 Typical High $2,290.87 | Facility | None | $23.44 | $85.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $18.62 Typical High $28.84 | Professional | None | $15.14 | $18.62 | $28.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
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 $13.49 Median $17.38 Typical High $23.99 | Professional | None | $13.49 | $17.38 | $23.99 |
2 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 55 · Aftercare only Typical Low $2.14 Median $2.40 Typical High $2.63 | Professional | 55 · Aftercare only | $2.14 | $2.40 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.58 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.41 | $1.58 | $1.74 |
Where Delaware sits
The same service costs 3.9 times more in Alaska than in New Jersey. 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· 46th of 51
$17.78
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.