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 $87.10 Median $123.03 Typical High $7,244.36 | Facility | None | $87.10 | $123.03 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $123.03 | Professional | None | $87.10 | $97.72 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $112.20 Typical High $162.18 | Facility | None | $58.88 | $112.20 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $162.18 | Professional | None | $93.33 | $117.49 | $162.18 |
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 $72.44 Median $97.72 Typical High $173.78 | Professional | None | $72.44 | $97.72 | $173.78 |
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 $43.65 Median $48.98 Typical High $61.66 | Professional | 52 · Reduced service | $43.65 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.50 Typical High $24.55 | Professional | 53 · Discontinued | $17.38 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $72.44 Typical High $91.20 | Professional | 54 · Surgery only | $64.57 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.45 Typical High $18.20 | Professional | 55 · Aftercare only | $12.88 | $14.45 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.77 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.71 | $9.77 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $67.61 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $60.26 | $67.61 | $85.11 |
Where Delaware sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 44th of 51
$110
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.