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 $38.02 Median $64.57 Typical High $7,244.36 | Facility | None | $38.02 | $64.57 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $93.33 | Professional | None | $39.81 | $57.54 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $69.18 Typical High $588.84 | Facility | None | $46.77 | $69.18 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $66.07 Typical High $107.15 | Professional | None | $42.66 | $66.07 | $107.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $676.08 Median $851.14 Typical High $1,584.89 | Facility | None | $676.08 | $851.14 | $1,584.89 |
Highmark BCBS Setting Professional Modifier None Typical Low $41.69 Median $67.61 Typical High $120.23 | Professional | None | $41.69 | $67.61 | $120.23 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $77.62 | Professional | None | $34.67 | $51.29 | $77.62 |
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 $20.42 Median $22.91 Typical High $32.36 | Professional | 52 · Reduced service | $20.42 | $22.91 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $9.12 Typical High $12.88 | Professional | 53 · Discontinued | $8.13 | $9.12 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $33.88 Typical High $47.86 | Professional | 54 · Surgery only | $30.20 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.76 Typical High $9.77 | Professional | 55 · Aftercare only | $6.03 | $6.76 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.57 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.07 | $4.57 | $6.46 |
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· 40th of 51
$60.26
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.