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 $117.49 Median $309.03 Typical High $7,244.36 | Facility | None | $117.49 | $309.03 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $263.03 | Professional | None | $112.20 | $117.49 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $707.95 Typical High $7,079.46 | Facility | None | $204.17 | $707.95 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $213.80 | Professional | None | $107.15 | $117.49 | $213.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Highmark BCBS Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $323.59 | Professional | None | $114.82 | $131.83 | $323.59 |
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 $95.50 Median $109.65 Typical High $165.96 | Professional | None | $95.50 | $109.65 | $165.96 |
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 $56.23 Median $58.88 Typical High $60.26 | Professional | 52 · Reduced service | $56.23 | $58.88 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.44 Typical High $23.99 | Professional | 53 · Discontinued | $22.39 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $87.10 Typical High $91.20 | Professional | 54 · Surgery only | $85.11 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $18.20 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.75 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.22 | $11.75 | $12.02 |
Where Delaware sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 51st of 51
$117
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.