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 $181.97 Median $263.03 Typical High $7,244.36 | Facility | None | $181.97 | $263.03 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $331.13 | Professional | None | $181.97 | $251.19 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $245.47 Typical High $363.08 | Facility | None | $58.88 | $245.47 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $371.54 | Professional | None | $181.97 | $257.04 | $371.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $977.24 | Facility | None | $398.11 | $398.11 | $977.24 |
Highmark BCBS Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
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 $169.82 Median $245.47 Typical High $380.19 | Professional | None | $169.82 | $245.47 | $380.19 |
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 $91.20 Median $104.71 Typical High $134.90 | Professional | 52 · Reduced service | $91.20 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $41.69 Typical High $54.95 | Professional | 53 · Discontinued | $36.31 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $158.49 Typical High $204.17 | Professional | 54 · Surgery only | $134.90 | $158.49 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $31.62 Typical High $40.74 | Professional | 55 · Aftercare only | $26.92 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.89 Typical High $27.54 | Professional | 56 · Pre-op care only | $18.20 | $20.89 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $147.91 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $125.89 | $147.91 | $190.55 |
Where Delaware sits
The same service costs 3.9 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· 43rd of 51
$263
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.