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 $114.82 Median $204.17 Typical High $7,244.36 | Facility | None | $114.82 | $204.17 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $208.93 | Professional | None | $114.82 | $134.90 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $85.11 Typical High $208.93 | Facility | None | $56.23 | $85.11 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $316.23 | Professional | None | $123.03 | $199.53 | $316.23 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $302.00 | Professional | None | $112.20 | $177.83 | $302.00 |
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 $57.54 Median $67.61 Typical High $104.71 | Professional | 52 · Reduced service | $57.54 | $67.61 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $26.92 Typical High $41.69 | Professional | 53 · Discontinued | $22.91 | $26.92 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $102.33 Typical High $158.49 | Professional | 54 · Surgery only | $87.10 | $102.33 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.42 Typical High $31.62 | Professional | 55 · Aftercare only | $17.38 | $20.42 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.49 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.48 | $13.49 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $95.50 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $81.28 | $95.50 | $147.91 |
Where Delaware sits
The same service costs 3.8 times more in Alaska than in Maryland. 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· 48th of 51
$170
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.