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 $186.21 Median $346.74 Typical High $7,244.36 | Facility | None | $186.21 | $346.74 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $371.54 | Professional | None | $186.21 | $223.87 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $85.11 Typical High $331.13 | Facility | None | $56.23 | $85.11 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $575.44 | Professional | None | $199.53 | $354.81 | $575.44 |
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 $190.55 Median $309.03 Typical High $524.81 | Professional | None | $190.55 | $309.03 | $524.81 |
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 $93.33 Median $112.20 Typical High $186.21 | Professional | 52 · Reduced service | $93.33 | $112.20 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $44.67 Typical High $74.13 | Professional | 53 · Discontinued | $37.15 | $44.67 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $165.96 Typical High $281.84 | Professional | 54 · Surgery only | $141.25 | $165.96 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.11 Typical High $56.23 | Professional | 55 · Aftercare only | $28.18 | $33.11 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.39 Typical High $37.15 | Professional | 56 · Pre-op care only | $18.62 | $22.39 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $154.88 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $131.83 | $154.88 | $263.03 |
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· 42nd of 51
$302
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.