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 $758.58 Median $1,995.26 Typical High $7,585.78 | Facility | None | $758.58 | $1,995.26 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $794.33 | Professional | None | $707.95 | $758.58 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $3,801.89 Typical High $5,888.44 | Facility | None | $1,258.93 | $3,801.89 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $676.08 Typical High $1,258.93 | Professional | None | $660.69 | $676.08 | $1,258.93 |
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 $549.54 Median $660.69 Typical High $977.24 | Professional | None | $549.54 | $660.69 | $977.24 |
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 $354.81 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $354.81 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $537.03 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $70.79 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $524.81 |
Where Delaware sits
The same service costs 17.4 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
$741
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.