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 $134.90 Median $181.97 Typical High $3,235.94 | Facility | None | $134.90 | $181.97 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $288.40 | Professional | None | $134.90 | $181.97 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $229.09 Typical High $588.84 | Facility | None | $144.54 | $229.09 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $288.40 | Professional | None | $144.54 | $213.80 | $288.40 |
Highmark BCBS Setting Facility Modifier None Typical Low $67.61 Median $3,388.44 Typical High $8,317.64 | Facility | None | $67.61 | $3,388.44 | $8,317.64 |
Highmark BCBS Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | None | $186.21 | $204.17 | $204.17 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $257.04 | Professional | None | $123.03 | $169.82 | $257.04 |
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 $67.61 Median $77.62 Typical High $93.33 | Professional | 52 · Reduced service | $67.61 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $30.90 Typical High $38.02 | Professional | 53 · Discontinued | $26.92 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $117.49 Typical High $141.25 | Professional | 54 · Surgery only | $102.33 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $23.44 Typical High $28.18 | Professional | 55 · Aftercare only | $20.42 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $15.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.49 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $109.65 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $95.50 | $109.65 | $131.83 |
Where Delaware sits
The same service costs 4.0 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
$195
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.