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 $95.50 Median $141.25 Typical High $4,073.80 | Facility | None | $95.50 | $141.25 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $194.98 | Professional | None | $95.50 | $131.83 | $194.98 |
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 $102.33 Median $165.96 Typical High $199.53 | Professional | None | $102.33 | $165.96 | $199.53 |
Highmark BCBS Setting Facility Modifier None Typical Low $114.82 Median $977.24 Typical High $6,456.54 | Facility | None | $114.82 | $977.24 | $6,456.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | None | $151.36 | $151.36 | $158.49 |
United Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,698.24 | Facility | None | $229.09 | $398.11 | $1,698.24 |
United Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $199.53 | Professional | None | $91.20 | $131.83 | $199.53 |
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 $47.86 Median $56.23 Typical High $72.44 | Professional | 52 · Reduced service | $47.86 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $22.39 Typical High $29.51 | Professional | 53 · Discontinued | $19.05 | $22.39 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $83.18 Typical High $109.65 | Professional | 54 · Surgery only | $70.79 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $16.60 Typical High $21.88 | Professional | 55 · Aftercare only | $14.13 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.22 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.55 | $11.22 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $77.62 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $66.07 | $77.62 | $102.33 |
Where Delaware sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$145
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.