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 $1,230.27 Median $6,606.93 Typical High $7,244.36 | Facility | None | $1,230.27 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,258.93 | Professional | None | $1,122.02 | $1,230.27 | $1,258.93 |
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 $1,071.52 Median $1,174.90 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,174.90 | $2,187.76 |
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 $1,023.29 Median $1,096.48 Typical High $1,698.24 | Professional | None | $1,023.29 | $1,096.48 | $1,698.24 |
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 $588.84 Median $616.60 Typical High $630.96 | Professional | 52 · Reduced service | $588.84 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $245.47 Typical High $251.19 | Professional | 53 · Discontinued | $234.42 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $954.99 | Professional | 54 · Surgery only | $891.25 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $186.21 Typical High $190.55 | Professional | 55 · Aftercare only | $177.83 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $123.03 Typical High $125.89 | Professional | 56 · Pre-op care only | $117.49 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $891.25 |
Where Delaware sits
The same service costs 14.5 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· 46th of 51
$1,202
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.