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 $60.26 Median $138.04 Typical High $7,244.36 | Facility | None | $60.26 | $138.04 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $138.04 | Professional | None | $60.26 | $89.13 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $933.25 Typical High $1,445.44 | Facility | None | $416.87 | $933.25 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $128.82 Typical High $223.87 | Professional | None | $63.10 | $128.82 | $223.87 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $60.26 Median $123.03 Typical High $208.93 | Professional | None | $60.26 | $123.03 | $208.93 |
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 $30.20 Median $31.62 Typical High $69.18 | Professional | 52 · Reduced service | $30.20 | $31.62 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $27.54 | Professional | 53 · Discontinued | $12.02 | $12.59 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $47.86 Typical High $104.71 | Professional | 54 · Surgery only | $45.71 | $47.86 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.55 Typical High $20.89 | Professional | 55 · Aftercare only | $9.12 | $9.55 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $13.80 |
Where Delaware sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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· 43rd 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.