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 $1,698.24 Median $6,025.60 Typical High $7,244.36 | Facility | None | $1,698.24 | $6,025.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,548.82 | $1,698.24 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,786.30 Typical High $7,585.78 | Facility | None | $676.08 | $4,786.30 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,548.82 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,548.82 | $3,019.95 |
Highmark BCBS Setting Facility Modifier None Typical Low $16,218.10 Median $16,218.10 Typical High $16,218.10 | Facility | None | $16,218.10 | $16,218.10 | $16,218.10 |
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 $1,288.25 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,513.56 | $2,290.87 |
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 $812.83 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $812.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $323.59 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,230.27 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,202.26 | $1,202.26 |
Where Delaware sits
The same service costs 18.2 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
$1,622
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.