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 $165.96 Median $436.52 Typical High $7,244.36 | Facility | None | $165.96 | $436.52 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $295.12 | Professional | None | $165.96 | $229.09 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $288.40 Typical High $588.84 | Facility | None | $190.55 | $288.40 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $346.74 | Professional | None | $165.96 | $245.47 | $346.74 |
Highmark BCBS Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $977.24 | Facility | None | $190.55 | $190.55 | $977.24 |
Highmark BCBS Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $275.42 | Professional | None | $218.78 | $263.03 | $275.42 |
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 $154.88 Median $229.09 Typical High $354.81 | Professional | None | $154.88 | $229.09 | $354.81 |
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 $83.18 Median $97.72 Typical High $128.82 | Professional | 52 · Reduced service | $83.18 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $38.90 Typical High $51.29 | Professional | 53 · Discontinued | $33.11 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $144.54 Typical High $190.55 | Professional | 54 · Surgery only | $125.89 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $29.51 Typical High $38.02 | Professional | 55 · Aftercare only | $25.12 | $29.51 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.50 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.60 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $134.90 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $117.49 | $134.90 | $177.83 |
Where Delaware sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$245
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.