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 $42.66 Median $45.71 Typical High $7,244.36 | Facility | None | $42.66 | $45.71 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $50.12 | Professional | None | $42.66 | $45.71 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $74.13 Typical High $151.36 | Facility | None | $56.23 | $74.13 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $77.62 | Professional | None | $42.66 | $44.67 | $77.62 |
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 $38.02 Median $48.98 Typical High $69.18 | Professional | None | $38.02 | $48.98 | $69.18 |
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 $21.38 Median $22.91 Typical High $24.55 | Professional | 52 · Reduced service | $21.38 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $9.12 Typical High $10.00 | Professional | 53 · Discontinued | $8.51 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $33.88 Typical High $37.15 | Professional | 54 · Surgery only | $32.36 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.92 Typical High $7.41 | Professional | 55 · Aftercare only | $6.46 | $6.92 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.57 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.27 | $4.57 | $5.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $30.20 Median $31.62 Typical High $34.67 | Professional | 78 · Unplanned return to OR | $30.20 | $31.62 | $34.67 |
Where Delaware sits
The same service costs 4.6 times more in Alaska than in New York. 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
$48.98
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.