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 $2,754.23 Median $2,754.23 Typical High $7,244.36 | Facility | None | $2,754.23 | $2,754.23 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,454.71 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $17,378.01 Typical High $27,542.29 | Facility | None | $676.08 | $17,378.01 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $4,677.35 | Professional | None | $2,238.72 | $2,238.72 | $4,677.35 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $5,128.61 Typical High $10,000.00 | Facility | None | $3,019.95 | $5,128.61 | $10,000.00 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,862.09 | $2,344.23 | $3,548.13 |
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 $1,230.27 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,230.27 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $489.78 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,862.09 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $371.54 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $245.47 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,905.46 | $1,905.46 |
Where Delaware sits
The same service costs 20.0 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
$2,630
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.