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 $223.87 Median $380.19 Typical High $4,897.79 | Facility | None | $223.87 | $380.19 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $524.81 | Professional | None | $223.87 | $363.08 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $380.19 Typical High $1,905.46 | Facility | None | $245.47 | $380.19 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $549.54 | Professional | None | $257.04 | $389.05 | $549.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $295.12 Median $2,137.96 Typical High $4,168.69 | Facility | None | $295.12 | $2,137.96 | $4,168.69 |
Highmark BCBS Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $218.78 Median $346.74 Typical High $537.03 | Professional | None | $218.78 | $346.74 | $537.03 |
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 $112.20 Median $128.82 Typical High $194.98 | Professional | 52 · Reduced service | $112.20 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $51.29 Typical High $77.62 | Professional | 53 · Discontinued | $44.67 | $51.29 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $194.98 Typical High $295.12 | Professional | 54 · Surgery only | $165.96 | $194.98 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $38.90 Typical High $58.88 | Professional | 55 · Aftercare only | $33.11 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.70 Typical High $38.90 | Professional | 56 · Pre-op care only | $22.39 | $25.70 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $181.97 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $154.88 | $181.97 | $275.42 |
Where Delaware sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$363
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.