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 $147.91 Median $218.78 Typical High $7,244.36 | Facility | None | $147.91 | $218.78 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $323.59 | Professional | None | $144.54 | $194.98 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $257.04 Typical High $588.84 | Facility | None | $173.78 | $257.04 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $363.08 | Professional | None | $147.91 | $229.09 | $363.08 |
Highmark BCBS Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $199.53 | Facility | None | $194.98 | $194.98 | $199.53 |
Highmark BCBS Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,698.24 | Facility | None | $229.09 | $398.11 | $1,698.24 |
United Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $251.19 | Professional | None | $123.03 | $165.96 | $251.19 |
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 $72.44 Median $77.62 Typical High $109.65 | Professional | 52 · Reduced service | $72.44 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.90 Typical High $44.67 | Professional | 53 · Discontinued | $28.84 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $114.82 Typical High $165.96 | Professional | 54 · Surgery only | $109.65 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.91 Typical High $33.11 | Professional | 55 · Aftercare only | $21.88 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.45 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $107.15 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $102.33 | $107.15 | $154.88 |
Where Delaware sits
The same service costs 3.5 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
$195
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.