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 $213.80 Median $354.81 Typical High $7,244.36 | Facility | None | $213.80 | $354.81 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $478.63 | Professional | None | $213.80 | $338.84 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $645.65 Typical High $1,905.46 | Facility | None | $426.58 | $645.65 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $512.86 | Professional | None | $239.88 | $354.81 | $512.86 |
Highmark BCBS Setting Facility Modifier None Typical Low $295.12 Median $812.83 Typical High $3,019.95 | Facility | None | $295.12 | $812.83 | $3,019.95 |
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 $208.93 Median $316.23 Typical High $501.19 | Professional | None | $208.93 | $316.23 | $501.19 |
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 $107.15 Median $125.89 Typical High $181.97 | Professional | 52 · Reduced service | $107.15 | $125.89 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $50.12 Typical High $72.44 | Professional | 53 · Discontinued | $42.66 | $50.12 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $186.21 Typical High $275.42 | Professional | 54 · Surgery only | $162.18 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $37.15 Typical High $54.95 | Professional | 55 · Aftercare only | $32.36 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $25.12 Typical High $36.31 | Professional | 56 · Pre-op care only | $21.38 | $25.12 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $173.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $151.36 | $173.78 | $257.04 |
Where Delaware sits
The same service costs 3.3 times more in Alaska than in Utah. 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· 45th of 51
$339
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.