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 $190.55 Median $501.19 Typical High $7,244.36 | Facility | None | $190.55 | $501.19 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $426.58 | Professional | None | $190.55 | $323.59 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $363.08 Typical High $1,288.25 | Facility | None | $245.47 | $363.08 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $478.63 | Professional | None | $208.93 | $363.08 | $478.63 |
Highmark BCBS Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $1,122.02 | Facility | None | $398.11 | $398.11 | $1,122.02 |
Highmark BCBS Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $181.97 Median $281.84 Typical High $467.74 | Professional | None | $181.97 | $281.84 | $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 $95.50 Median $109.65 Typical High $177.83 | Professional | 52 · Reduced service | $95.50 | $109.65 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $43.65 Typical High $70.79 | Professional | 53 · Discontinued | $38.02 | $43.65 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $165.96 Typical High $269.15 | Professional | 54 · Surgery only | $141.25 | $165.96 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.11 Typical High $53.70 | Professional | 55 · Aftercare only | $28.18 | $33.11 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $19.05 | $21.88 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $154.88 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $131.83 | $154.88 | $251.19 |
Where Delaware sits
The same service costs 3.5 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· 44th of 51
$316
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.