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 $89.13 Median $147.91 Typical High $7,244.36 | Facility | None | $89.13 | $147.91 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $165.96 | Professional | None | $89.13 | $125.89 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $144.54 Typical High $208.93 | Facility | None | $58.88 | $144.54 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $204.17 | Professional | None | $95.50 | $144.54 | $204.17 |
Highmark BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
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 $87.10 Median $128.82 Typical High $204.17 | Professional | None | $87.10 | $128.82 | $204.17 |
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 $44.67 Median $52.48 Typical High $75.86 | Professional | 52 · Reduced service | $44.67 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $21.38 Typical High $30.20 | Professional | 53 · Discontinued | $17.78 | $21.38 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $79.43 Typical High $112.20 | Professional | 54 · Surgery only | $67.61 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.85 Typical High $22.39 | Professional | 55 · Aftercare only | $13.49 | $15.85 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.72 Typical High $15.14 | Professional | 56 · Pre-op care only | $8.91 | $10.72 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $74.13 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $63.10 | $74.13 | $104.71 |
Where Delaware sits
The same service costs 3.5 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· 48th of 51
$138
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.