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 $741.31 Median $7,244.36 Typical High $7,585.78 | Facility | None | $741.31 | $7,244.36 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $776.25 | Professional | None | $707.95 | $741.31 | $776.25 |
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 $1,318.26 | Professional | None | $660.69 | $676.08 | $1,318.26 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $562.34 Median $645.65 Typical High $1,000.00 | Professional | None | $562.34 | $645.65 | $1,000.00 |
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 $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $354.81 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $141.25 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $537.03 | $549.54 | $549.54 |
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 $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $70.79 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $501.19 | $512.86 | $512.86 |
Where Delaware sits
The same service costs 8.5 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.