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 $660.69 Median $794.33 Typical High $7,244.36 | Facility | None | $660.69 | $794.33 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $812.83 | Professional | None | $645.65 | $758.58 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $3,311.31 Typical High $5,888.44 | Facility | None | $616.60 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,348.96 | Professional | None | $691.83 | $912.01 | $1,348.96 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | None | $5,370.32 | $5,370.32 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $3,981.07 | Facility | None | $1,412.54 | $2,398.83 | $3,981.07 |
United Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,174.90 | Professional | None | $588.84 | $724.44 | $1,174.90 |
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 $331.13 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $331.13 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $158.49 | Professional | 53 · Discontinued | $131.83 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $588.84 | Professional | 54 · Surgery only | $489.78 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $117.49 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $79.43 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $549.54 |
Where Delaware sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 39th of 51
$794
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.