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 $275.42 Median $724.44 Typical High $7,244.36 | Facility | None | $275.42 | $724.44 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $457.09 | Professional | None | $275.42 | $338.84 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,584.89 Typical High $2,454.71 | Facility | None | $562.34 | $1,584.89 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $562.34 | Professional | None | $281.84 | $371.54 | $562.34 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,630.78 | Facility | None | $2,691.53 | $2,691.53 | $3,630.78 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $489.78 | Professional | None | $257.04 | $338.84 | $489.78 |
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 $138.04 Median $158.49 Typical High $181.97 | Professional | 52 · Reduced service | $138.04 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $63.10 Typical High $72.44 | Professional | 53 · Discontinued | $56.23 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $269.15 | Professional | 54 · Surgery only | $208.93 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $31.62 Typical High $36.31 | Professional | 56 · Pre-op care only | $27.54 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $218.78 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $194.98 | $218.78 | $251.19 |
Where Delaware sits
The same service costs 4.5 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· 41st of 51
$372
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.