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 $2,818.38 Median $6,025.60 Typical High $7,244.36 | Facility | None | $2,818.38 | $6,025.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $2,884.03 | Professional | None | $2,511.89 | $2,818.38 | $2,884.03 |
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 $2,454.71 Median $2,754.23 Typical High $5,011.87 | Professional | None | $2,454.71 | $2,754.23 | $5,011.87 |
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 $2,187.76 Median $2,511.89 Typical High $3,801.89 | Professional | None | $2,187.76 | $2,511.89 | $3,801.89 |
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 $1,348.96 Median $1,412.54 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,348.96 | $1,412.54 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $562.34 Typical High $575.44 | Professional | 53 · Discontinued | $537.03 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,089.30 Typical High $2,187.76 | Professional | 54 · Surgery only | $2,041.74 | $2,089.30 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $416.87 Typical High $436.52 | Professional | 55 · Aftercare only | $407.38 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $281.84 Typical High $288.40 | Professional | 56 · Pre-op care only | $269.15 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $1,949.84 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,905.46 | $1,949.84 | $2,041.74 |
Where Delaware sits
The same service costs 20.9 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· 44th of 51
$2,754
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.