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 $575.44 Median $794.33 Typical High $4,897.79 | Facility | None | $575.44 | $794.33 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $912.01 | Professional | None | $575.44 | $676.08 | $912.01 |
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 $588.84 Median $707.95 Typical High $1,071.52 | Professional | None | $588.84 | $707.95 | $1,071.52 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,288.25 | $2,398.83 | $6,918.31 |
Highmark BCBS Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $776.25 | Professional | None | $616.60 | $616.60 | $776.25 |
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 $549.54 Median $707.95 Typical High $1,023.29 | Professional | None | $549.54 | $707.95 | $1,023.29 |
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 $288.40 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $288.40 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $114.82 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $489.78 Typical High $524.81 | Professional | 54 · Surgery only | $426.58 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $87.10 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $66.07 Typical High $70.79 | Professional | 56 · Pre-op care only | $57.54 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $457.09 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $398.11 | $457.09 | $489.78 |
Where Delaware sits
The same service costs 4.6 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· 43rd of 51
$708
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.