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 $123.03 Median $245.47 Typical High $7,244.36 | Facility | None | $123.03 | $245.47 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $245.47 | Professional | None | $123.03 | $131.83 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,137.96 Typical High $3,162.28 | Facility | None | $645.65 | $2,137.96 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $426.58 | Professional | None | $128.82 | $194.98 | $426.58 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $3,388.44 | Facility | None | $1,023.29 | $1,819.70 | $3,388.44 |
United Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $426.58 | Professional | None | $123.03 | $194.98 | $426.58 |
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 $61.66 Median $66.07 Typical High $123.03 | Professional | 52 · Reduced service | $61.66 | $66.07 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.30 Typical High $48.98 | Professional | 53 · Discontinued | $24.55 | $26.30 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $100.00 Typical High $186.21 | Professional | 54 · Surgery only | $93.33 | $100.00 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $37.15 | Professional | 55 · Aftercare only | $18.62 | $19.95 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.18 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.30 | $13.18 | $24.55 |
Where Delaware sits
The same service costs 5.8 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· 46th of 51
$245
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.