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 $147.91 Median $223.87 Typical High $7,244.36 | Facility | None | $147.91 | $223.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $288.40 | Professional | None | $147.91 | $213.80 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $263.03 Typical High $588.84 | Facility | None | $177.83 | $263.03 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $316.23 | Professional | None | $147.91 | $218.78 | $316.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $6,309.57 | Facility | None | $1,023.29 | $1,023.29 | $6,309.57 |
Highmark BCBS Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | None | $229.09 | $251.19 | $251.19 |
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 $141.25 Median $204.17 Typical High $316.23 | Professional | None | $141.25 | $204.17 | $316.23 |
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 $72.44 Median $85.11 Typical High $114.82 | Professional | 52 · Reduced service | $72.44 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $33.88 Typical High $45.71 | Professional | 53 · Discontinued | $29.51 | $33.88 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $128.82 Typical High $173.78 | Professional | 54 · Surgery only | $109.65 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.70 Typical High $34.67 | Professional | 55 · Aftercare only | $21.88 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.98 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.79 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $120.23 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $102.33 | $120.23 | $162.18 |
Where Delaware sits
The same service costs 3.4 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· 44th of 51
$224
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.