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 $257.04 Median $380.19 Typical High $3,235.94 | Facility | None | $257.04 | $380.19 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $478.63 | Professional | None | $257.04 | $323.59 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $426.58 Typical High $645.65 | Facility | None | $85.11 | $426.58 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $489.78 | Professional | None | $263.03 | $338.84 | $489.78 |
Highmark BCBS Setting Facility Modifier None Typical Low $316.23 Median $616.60 Typical High $8,317.64 | Facility | None | $316.23 | $616.60 | $8,317.64 |
United Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,698.24 | Facility | None | $229.09 | $398.11 | $1,698.24 |
United Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $457.09 | Professional | None | $218.78 | $302.00 | $457.09 |
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 $128.82 Median $138.04 Typical High $190.55 | Professional | 52 · Reduced service | $128.82 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $75.86 | Professional | 53 · Discontinued | $51.29 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $204.17 Typical High $281.84 | Professional | 54 · Surgery only | $194.98 | $204.17 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $41.69 Typical High $57.54 | Professional | 55 · Aftercare only | $38.90 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $38.02 | Professional | 56 · Pre-op care only | $25.70 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $190.55 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $181.97 | $190.55 | $269.15 |
Where Delaware sits
The same service costs 4.5 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· 44th of 51
$316
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.