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 $91.20 Median $239.88 Typical High $7,244.36 | Facility | None | $91.20 | $239.88 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $208.93 | Professional | None | $91.20 | $125.89 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $173.78 Typical High $588.84 | Facility | None | $117.49 | $173.78 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $190.55 | Professional | None | $97.72 | $162.18 | $190.55 |
Highmark BCBS Setting Facility Modifier None Typical Low $97.72 Median $2,951.21 Typical High $5,128.61 | Facility | None | $97.72 | $2,951.21 | $5,128.61 |
Highmark BCBS Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $154.88 | Professional | None | $131.83 | $154.88 | $154.88 |
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 $85.11 Median $123.03 Typical High $190.55 | Professional | None | $85.11 | $123.03 | $190.55 |
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 $45.71 Median $54.95 Typical High $70.79 | Professional | 52 · Reduced service | $45.71 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $21.88 Typical High $28.18 | Professional | 53 · Discontinued | $18.62 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $81.28 Typical High $107.15 | Professional | 54 · Surgery only | $69.18 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.22 Typical High $21.38 | Professional | 55 · Aftercare only | $13.80 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.96 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.12 | $10.96 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $75.86 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $64.57 | $75.86 | $100.00 |
Where Delaware sits
The same service costs 3.7 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· 39th of 51
$138
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.