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 $104.71 Median $165.96 Typical High $3,235.94 | Facility | None | $104.71 | $165.96 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $269.15 | Professional | None | $104.71 | $165.96 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $165.96 Typical High $588.84 | Facility | None | $112.20 | $165.96 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $251.19 | Professional | None | $117.49 | $165.96 | $251.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $63.10 Median $1,122.02 Typical High $6,309.57 | Facility | None | $63.10 | $1,122.02 | $6,309.57 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $239.88 | Professional | None | $85.11 | $147.91 | $239.88 |
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 $46.77 Median $67.61 Typical High $83.18 | Professional | 52 · Reduced service | $46.77 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $26.92 Typical High $33.11 | Professional | 53 · Discontinued | $19.05 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $102.33 Typical High $125.89 | Professional | 54 · Surgery only | $70.79 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $20.42 Typical High $25.12 | Professional | 55 · Aftercare only | $14.13 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.49 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.33 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $95.50 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $66.07 | $95.50 | $117.49 |
Where Delaware sits
The same service costs 3.2 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· 40th of 51
$162
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.