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 $3,890.45 Median $3,890.45 Typical High $7,244.36 | Facility | None | $3,890.45 | $3,890.45 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $3,630.78 Median $3,890.45 Typical High $4,073.80 | Professional | None | $3,630.78 | $3,890.45 | $4,073.80 |
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 $3,467.37 Median $3,801.89 Typical High $7,079.46 | Professional | None | $3,467.37 | $3,801.89 | $7,079.46 |
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 $3,235.94 Median $3,548.13 Typical High $5,623.41 | Professional | None | $3,235.94 | $3,548.13 | $5,623.41 |
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 $1,905.46 Median $1,949.84 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,905.46 | $1,949.84 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $776.25 Typical High $812.83 | Professional | 53 · Discontinued | $758.58 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $2,951.21 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,884.03 | $2,951.21 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $588.84 Typical High $616.60 | Professional | 55 · Aftercare only | $575.44 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $389.05 Typical High $407.38 | Professional | 56 · Pre-op care only | $380.19 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,754.23 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,754.23 | $2,818.38 |
Where Delaware sits
The same service costs 20.4 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
$3,802
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.