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 $245.47 Median $645.65 Typical High $7,244.36 | Facility | None | $245.47 | $645.65 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $389.05 | Professional | None | $245.47 | $309.03 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,479.11 | Facility | None | $562.34 | $1,000.00 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $501.19 | Professional | None | $257.04 | $338.84 | $501.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $1,380.38 | Facility | None | $741.31 | $741.31 | $1,380.38 |
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 $229.09 Median $331.13 Typical High $489.78 | Professional | None | $229.09 | $331.13 | $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 $123.03 Median $141.25 Typical High $177.83 | Professional | 52 · Reduced service | $123.03 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $56.23 Typical High $72.44 | Professional | 53 · Discontinued | $48.98 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $213.80 Typical High $269.15 | Professional | 54 · Surgery only | $181.97 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $42.66 Typical High $53.70 | Professional | 55 · Aftercare only | $36.31 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.18 Typical High $36.31 | Professional | 56 · Pre-op care only | $24.55 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $199.53 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $169.82 | $199.53 | $251.19 |
Where Delaware sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 48th of 51
$347
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.