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 $93.33 Median $173.78 Typical High $7,244.36 | Facility | None | $93.33 | $173.78 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $173.78 | Professional | None | $83.18 | $117.49 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $85.11 Typical High $154.88 | Facility | None | $56.23 | $85.11 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $165.96 Typical High $199.53 | Professional | None | $87.10 | $165.96 | $199.53 |
Highmark BCBS Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $173.78 | Facility | None | $147.91 | $147.91 | $173.78 |
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 $64.57 Median $109.65 Typical High $204.17 | Professional | None | $64.57 | $109.65 | $204.17 |
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 $41.69 Median $50.12 Typical High $87.10 | Professional | 52 · Reduced service | $41.69 | $50.12 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.95 Typical High $34.67 | Professional | 53 · Discontinued | $16.60 | $19.95 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $74.13 Typical High $131.83 | Professional | 54 · Surgery only | $63.10 | $74.13 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.79 Typical High $26.30 | Professional | 55 · Aftercare only | $12.59 | $14.79 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.00 Typical High $17.38 | Professional | 56 · Pre-op care only | $8.32 | $10.00 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $69.18 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $58.88 | $69.18 | $123.03 |
Where Delaware sits
The same service costs 4.5 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
$123
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.