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 $1,318.26 Median $3,467.37 Typical High $7,244.36 | Facility | None | $1,318.26 | $3,467.37 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,318.26 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,801.89 Typical High $5,888.44 | Facility | None | $676.08 | $3,801.89 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,258.93 | $2,398.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $10,715.19 | Facility | None | $10,715.19 | $10,715.19 | $10,715.19 |
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 $1,071.52 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,174.90 | $1,819.70 |
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 $630.96 Median $660.69 Typical High $691.83 | Professional | 52 · Reduced service | $630.96 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $275.42 | Professional | 53 · Discontinued | $257.04 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,023.29 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $199.53 Typical High $204.17 | Professional | 55 · Aftercare only | $190.55 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $138.04 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $954.99 |
Where Delaware sits
The same service costs 15.1 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· 45th of 51
$1,318
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.