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 $316.23 Median $426.58 Typical High $7,244.36 | Facility | None | $316.23 | $426.58 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $467.74 | Professional | None | $316.23 | $389.05 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $489.78 Typical High $630.96 | Facility | None | $346.74 | $489.78 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $758.58 | Professional | None | $338.84 | $489.78 | $758.58 |
United Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,698.24 | Facility | None | $229.09 | $398.11 | $1,698.24 |
United Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $707.95 | Professional | None | $331.13 | $467.74 | $707.95 |
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 $158.49 Median $194.98 Typical High $234.42 | Professional | 52 · Reduced service | $158.49 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $77.62 Typical High $93.33 | Professional | 53 · Discontinued | $64.57 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $288.40 Typical High $346.74 | Professional | 54 · Surgery only | $239.88 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $57.54 Typical High $69.18 | Professional | 55 · Aftercare only | $47.86 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $38.90 Typical High $46.77 | Professional | 56 · Pre-op care only | $31.62 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $269.15 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $223.87 | $269.15 | $323.59 |
Where Delaware sits
The same service costs 5.1 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
$437
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.