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 $707.95 Median $1,621.81 Typical High $7,244.36 | Facility | None | $707.95 | $1,621.81 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $1,023.29 | Professional | None | $707.95 | $870.96 | $1,023.29 |
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 $741.31 Median $933.25 Typical High $1,445.44 | Professional | None | $741.31 | $933.25 | $1,445.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $2,818.38 Typical High $6,456.54 | Facility | None | $1,047.13 | $2,818.38 | $6,456.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $676.08 Median $954.99 Typical High $1,258.93 | Professional | None | $676.08 | $954.99 | $1,258.93 |
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 $354.81 Median $407.38 Typical High $457.09 | Professional | 52 · Reduced service | $354.81 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $162.18 Typical High $181.97 | Professional | 53 · Discontinued | $141.25 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $524.81 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $120.23 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $81.28 Typical High $91.20 | Professional | 56 · Pre-op care only | $70.79 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $562.34 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $489.78 | $562.34 | $630.96 |
Where Delaware sits
The same service costs 4.5 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
$891
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.