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 $891.25 Median $4,897.79 Typical High $7,244.36 | Facility | None | $891.25 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $933.25 | Professional | None | $776.25 | $891.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,513.56 Typical High $2,187.76 | Facility | None | $676.08 | $1,513.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,584.89 | Professional | None | $691.83 | $691.83 | $1,584.89 |
Highmark BCBS Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
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 $630.96 Median $741.31 Typical High $1,148.15 | Professional | None | $630.96 | $741.31 | $1,148.15 |
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 $407.38 Median $446.68 Typical High $457.09 | Professional | 52 · Reduced service | $407.38 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $181.97 | Professional | 53 · Discontinued | $162.18 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $676.08 | Professional | 54 · Surgery only | $616.60 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $134.90 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $91.20 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $630.96 |
Where Delaware sits
The same service costs 7.6 times more in Alaska than in Texas. 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· 45th of 51
$794
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.