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 $53.70 Median $123.03 Typical High $7,244.36 | Facility | None | $53.70 | $123.03 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $83.18 Typical High $138.04 | Professional | None | $53.70 | $83.18 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $125.89 Typical High $181.97 | Facility | None | $58.88 | $125.89 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $134.90 Typical High $144.54 | Professional | None | $58.88 | $134.90 | $144.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
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 $53.70 Median $83.18 Typical High $158.49 | Professional | None | $53.70 | $83.18 | $158.49 |
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 $26.92 Median $30.90 Typical High $63.10 | Professional | 52 · Reduced service | $26.92 | $30.90 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $12.30 Typical High $25.12 | Professional | 53 · Discontinued | $10.72 | $12.30 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $46.77 Typical High $93.33 | Professional | 54 · Surgery only | $40.74 | $46.77 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.33 Typical High $18.62 | Professional | 55 · Aftercare only | $8.13 | $9.33 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.17 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.37 | $6.17 | $12.59 |
Where Delaware sits
The same service costs 3.2 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· 44th of 51
$102
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.