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 $125.89 Median $234.42 Typical High $3,235.94 | Facility | None | $125.89 | $234.42 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $323.59 | Professional | None | $125.89 | $213.80 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $234.42 Typical High $363.08 | Facility | None | $58.88 | $234.42 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $323.59 | Professional | None | $144.54 | $251.19 | $323.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $436.52 Median $1,318.26 Typical High $2,691.53 | Facility | None | $436.52 | $1,318.26 | $2,691.53 |
Highmark BCBS Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
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 $123.03 Median $194.98 Typical High $316.23 | Professional | None | $123.03 | $194.98 | $316.23 |
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 $63.10 Median $72.44 Typical High $120.23 | Professional | 52 · Reduced service | $63.10 | $72.44 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $29.51 Typical High $47.86 | Professional | 53 · Discontinued | $25.12 | $29.51 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $109.65 Typical High $181.97 | Professional | 54 · Surgery only | $93.33 | $109.65 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.88 Typical High $36.31 | Professional | 55 · Aftercare only | $18.62 | $21.88 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.79 Typical High $23.99 | Professional | 56 · Pre-op care only | $12.59 | $14.79 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $102.33 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $87.10 | $102.33 | $169.82 |
Where Delaware sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 42nd of 51
$219
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.