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 $354.81 Median $630.96 Typical High $7,244.36 | Facility | None | $354.81 | $630.96 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $630.96 | Professional | None | $354.81 | $537.03 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $3,311.31 Typical High $5,888.44 | Facility | None | $575.44 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $1,023.29 | Professional | None | $371.54 | $575.44 | $1,023.29 |
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 $309.03 Median $537.03 Typical High $851.14 | Professional | None | $309.03 | $537.03 | $851.14 |
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 $177.83 Median $204.17 Typical High $316.23 | Professional | 52 · Reduced service | $177.83 | $204.17 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $81.28 Typical High $125.89 | Professional | 53 · Discontinued | $70.79 | $81.28 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $302.00 Typical High $478.63 | Professional | 54 · Surgery only | $263.03 | $302.00 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $60.26 Typical High $95.50 | Professional | 55 · Aftercare only | $52.48 | $60.26 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $40.74 Typical High $63.10 | Professional | 56 · Pre-op care only | $35.48 | $40.74 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $281.84 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $245.47 | $281.84 | $446.68 |
Where Delaware sits
The same service costs 4.9 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· 41st of 51
$562
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.