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 $2,041.74 Median $2,041.74 Typical High $7,244.36 | Facility | None | $2,041.74 | $2,041.74 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,137.96 | Professional | None | $1,905.46 | $2,041.74 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,659.59 Typical High $2,290.87 | Facility | None | $676.08 | $1,659.59 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $3,715.35 | Professional | None | $1,905.46 | $2,344.23 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $5,011.87 | Facility | None | $1,584.89 | $2,818.38 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,737.80 | $1,995.26 | $3,388.44 |
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 $1,000.00 Median $1,023.29 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,000.00 | $1,023.29 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $407.38 Typical High $426.58 | Professional | 53 · Discontinued | $398.11 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,548.82 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,479.11 | $1,548.82 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $309.03 Typical High $316.23 | Professional | 55 · Aftercare only | $295.12 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $204.17 Typical High $213.80 | Professional | 56 · Pre-op care only | $199.53 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,445.44 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,445.44 | $1,479.11 |
Where Delaware sits
The same service costs 19.5 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· 43rd of 51
$2,138
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.