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 $57.54 Median $100.00 Typical High $7,244.36 | Facility | None | $57.54 | $100.00 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $95.50 Typical High $151.36 | Professional | None | $57.54 | $95.50 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $85.11 Typical High $151.36 | Facility | None | $56.23 | $85.11 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $138.04 | Professional | None | $56.23 | $93.33 | $138.04 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $97.72 Median $588.84 Typical High $588.84 | Professional | None | $97.72 | $588.84 | $588.84 |
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 $53.70 Median $85.11 Typical High $138.04 | Professional | None | $53.70 | $85.11 | $138.04 |
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 $28.84 Median $34.67 Typical High $50.12 | Professional | 52 · Reduced service | $28.84 | $34.67 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $13.80 Typical High $20.42 | Professional | 53 · Discontinued | $11.48 | $13.80 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $51.29 Typical High $75.86 | Professional | 54 · Surgery only | $43.65 | $51.29 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.47 Typical High $15.14 | Professional | 55 · Aftercare only | $8.71 | $10.47 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.92 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.75 | $6.92 | $10.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $40.74 Median $47.86 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $40.74 | $47.86 | $70.79 |
Where Delaware sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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
$93.33
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.