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 $186.21 Median $338.84 Typical High $7,244.36 | Facility | None | $186.21 | $338.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $398.11 | Professional | None | $186.21 | $295.12 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $616.60 Typical High $1,288.25 | Facility | None | $426.58 | $616.60 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $478.63 | Professional | None | $194.98 | $371.54 | $478.63 |
Highmark BCBS Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
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 $177.83 Median $275.42 Typical High $467.74 | Professional | None | $177.83 | $275.42 | $467.74 |
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 $93.33 Median $107.15 Typical High $173.78 | Professional | 52 · Reduced service | $93.33 | $107.15 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $42.66 Typical High $69.18 | Professional | 53 · Discontinued | $37.15 | $42.66 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $162.18 Typical High $263.03 | Professional | 54 · Surgery only | $138.04 | $162.18 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $52.48 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.38 Typical High $34.67 | Professional | 56 · Pre-op care only | $18.62 | $21.38 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $151.36 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $128.82 | $151.36 | $245.47 |
Where Delaware sits
The same service costs 3.4 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· 42nd of 51
$309
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.