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 $64.57 Median $147.91 Typical High $7,244.36 | Facility | None | $64.57 | $147.91 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $138.04 Typical High $165.96 | Professional | None | $64.57 | $138.04 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $239.88 | Professional | None | $75.86 | $141.25 | $239.88 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $67.61 Median $141.25 Typical High $251.19 | Professional | None | $67.61 | $141.25 | $251.19 |
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 $32.36 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $32.36 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $23.44 Typical High $30.20 | Professional | 53 · Discontinued | $12.88 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $87.10 Typical High $112.20 | Professional | 54 · Surgery only | $48.98 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $9.77 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.46 | $11.48 | $15.14 |
Where Delaware sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 41st of 51
$141
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.