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 $562.34 Median $691.83 Typical High $7,244.36 | Facility | None | $562.34 | $691.83 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $776.25 | Professional | None | $562.34 | $691.83 | $776.25 |
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 $724.44 Typical High $1,096.48 | Professional | None | $588.84 | $724.44 | $1,096.48 |
Highmark BCBS Setting Facility Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $10,715.19 | Facility | None | $10,715.19 | $10,715.19 | $10,715.19 |
Highmark BCBS Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $1,000.00 | Professional | None | $549.54 | $707.95 | $1,000.00 |
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 $281.84 Median $323.59 Typical High $363.08 | Professional | 52 · Reduced service | $281.84 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $128.82 Typical High $144.54 | Professional | 53 · Discontinued | $112.20 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $478.63 Typical High $549.54 | Professional | 54 · Surgery only | $426.58 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $95.50 Typical High $109.65 | Professional | 55 · Aftercare only | $85.11 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $64.57 Typical High $72.44 | Professional | 56 · Pre-op care only | $56.23 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $446.68 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $398.11 | $446.68 | $512.86 |
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
$692
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.