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 $354.81 Median $467.74 Typical High $7,244.36 | Facility | None | $354.81 | $467.74 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $489.78 | Professional | None | $354.81 | $416.87 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $478.63 Typical High $691.83 | Facility | None | $58.88 | $478.63 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $724.44 | Professional | None | $363.08 | $489.78 | $724.44 |
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 $338.84 Median $467.74 Typical High $676.08 | Professional | None | $338.84 | $467.74 | $676.08 |
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 $177.83 Median $208.93 Typical High $239.88 | Professional | 52 · Reduced service | $177.83 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $70.79 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $316.23 Typical High $363.08 | Professional | 54 · Surgery only | $263.03 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $63.10 Typical High $72.44 | Professional | 55 · Aftercare only | $53.70 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $35.48 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $295.12 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $245.47 | $295.12 | $338.84 |
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· 42nd of 51
$457
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.