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 $363.08 Median $954.99 Typical High $7,244.36 | Facility | None | $363.08 | $954.99 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $489.78 | Professional | None | $363.08 | $416.87 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $2,884.03 | Facility | None | $588.84 | $1,862.09 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $758.58 | Professional | None | $371.54 | $457.09 | $758.58 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $7,943.28 Typical High $8,709.64 | Facility | None | $7,585.78 | $7,943.28 | $8,709.64 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $660.69 | Professional | None | $323.59 | $416.87 | $660.69 |
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 $181.97 Median $204.17 Typical High $234.42 | Professional | 52 · Reduced service | $181.97 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $81.28 Typical High $95.50 | Professional | 53 · Discontinued | $72.44 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $302.00 Typical High $354.81 | Professional | 54 · Surgery only | $275.42 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $60.26 Typical High $70.79 | Professional | 55 · Aftercare only | $54.95 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $281.84 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $257.04 | $281.84 | $331.13 |
Where Delaware sits
The same service costs 6.0 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
$437
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.