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 $79.43 Median $107.15 Typical High $7,244.36 | Facility | None | $79.43 | $107.15 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $112.20 | Professional | None | $79.43 | $93.33 | $112.20 |
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 $85.11 Median $114.82 Typical High $165.96 | Professional | None | $85.11 | $114.82 | $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 $77.62 Median $107.15 Typical High $154.88 | Professional | None | $77.62 | $107.15 | $154.88 |
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 $39.81 Median $46.77 Typical High $56.23 | Professional | 52 · Reduced service | $39.81 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $18.62 Typical High $22.39 | Professional | 53 · Discontinued | $15.85 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $70.79 Typical High $83.18 | Professional | 54 · Surgery only | $58.88 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.13 Typical High $16.60 | Professional | 55 · Aftercare only | $11.75 | $14.13 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.33 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.94 | $9.33 | $11.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $66.07 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $54.95 | $66.07 | $77.62 |
Where Delaware sits
The same service costs 3.8 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· 45th of 51
$107
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.