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 $147.91 Median $288.40 Typical High $3,235.94 | Facility | None | $147.91 | $288.40 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $389.05 | Professional | None | $147.91 | $234.42 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $263.03 Typical High $389.05 | Facility | None | $58.88 | $263.03 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $346.74 | Professional | None | $169.82 | $269.15 | $346.74 |
Highmark BCBS Setting Facility Modifier None Typical Low $426.58 Median $1,122.02 Typical High $2,187.76 | Facility | None | $426.58 | $1,122.02 | $2,187.76 |
Highmark BCBS Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $141.25 Median $208.93 Typical High $338.84 | Professional | None | $141.25 | $208.93 | $338.84 |
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 $72.44 Median $85.11 Typical High $128.82 | Professional | 52 · Reduced service | $72.44 | $85.11 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $34.67 Typical High $51.29 | Professional | 53 · Discontinued | $29.51 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $128.82 Typical High $194.98 | Professional | 54 · Surgery only | $109.65 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.70 Typical High $38.90 | Professional | 55 · Aftercare only | $21.88 | $25.70 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.98 Typical High $25.70 | Professional | 56 · Pre-op care only | $14.79 | $16.98 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $120.23 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $102.33 | $120.23 | $181.97 |
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
$240
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.