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 $32.36 Median $79.43 Typical High $3,235.94 | Facility | None | $32.36 | $79.43 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $66.07 Typical High $104.71 | Professional | None | $32.36 | $66.07 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $61.66 Typical High $151.36 | Facility | None | $56.23 | $61.66 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $66.07 Typical High $112.20 | Professional | None | $33.88 | $66.07 | $112.20 |
Highmark BCBS Setting Facility Modifier None Typical Low $128.82 Median $549.54 Typical High $1,096.48 | Facility | None | $128.82 | $549.54 | $1,096.48 |
Highmark BCBS Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
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 $30.90 Median $56.23 Typical High $104.71 | Professional | None | $30.90 | $56.23 | $104.71 |
5 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 $16.22 Median $19.05 Typical High $40.74 | Professional | 52 · Reduced service | $16.22 | $19.05 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.59 Typical High $16.22 | Professional | 53 · Discontinued | $6.46 | $7.59 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $28.18 Typical High $60.26 | Professional | 54 · Surgery only | $24.55 | $28.18 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.62 Typical High $12.02 | Professional | 55 · Aftercare only | $4.90 | $5.62 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.80 Typical High $8.13 | Professional | 56 · Pre-op care only | $3.24 | $3.80 | $8.13 |
Where Delaware sits
The same service costs 3.7 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· 40th of 51
$70.79
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.