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 $81.28 Median $125.89 Typical High $3,235.94 | Facility | None | $81.28 | $125.89 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $144.54 | Professional | None | $81.28 | $117.49 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $134.90 Typical High $588.84 | Facility | None | $87.10 | $134.90 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $194.98 | Professional | None | $89.13 | $131.83 | $194.98 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | None | $5,370.32 | $5,370.32 | $5,370.32 |
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 $79.43 Median $120.23 Typical High $186.21 | Professional | None | $79.43 | $120.23 | $186.21 |
5 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 $40.74 Median $45.71 Typical High $67.61 | Professional | 52 · Reduced service | $40.74 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $18.62 Typical High $26.92 | Professional | 53 · Discontinued | $16.22 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $69.18 Typical High $102.33 | Professional | 54 · Surgery only | $60.26 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.80 Typical High $20.42 | Professional | 55 · Aftercare only | $12.02 | $13.80 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.12 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.13 | $9.12 | $13.49 |
Where Delaware sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 46th of 51
$126
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.