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 $489.78 Median $616.60 Typical High $7,244.36 | Facility | None | $489.78 | $616.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $831.76 | Professional | None | $489.78 | $602.56 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,513.56 Typical High $2,238.72 | Facility | None | $707.95 | $1,513.56 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $933.25 | Professional | None | $512.86 | $645.65 | $933.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $8,128.31 | Facility | None | $1,230.27 | $1,584.89 | $8,128.31 |
Highmark BCBS Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $691.83 | Professional | None | $575.44 | $575.44 | $691.83 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $870.96 | Professional | None | $467.74 | $602.56 | $870.96 |
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 $245.47 Median $281.84 Typical High $323.59 | Professional | 52 · Reduced service | $245.47 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $97.72 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $426.58 Typical High $478.63 | Professional | 54 · Surgery only | $371.54 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $74.13 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $48.98 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $398.11 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $346.74 | $398.11 | $446.68 |
Where Delaware sits
The same service costs 4.3 times more in Alaska than in Texas. 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· 46th of 51
$617
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.