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 $1,412.54 Median $6,025.60 Typical High $7,244.36 | Facility | None | $1,412.54 | $6,025.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,445.44 | Professional | None | $1,288.25 | $1,412.54 | $1,445.44 |
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 $1,258.93 Median $1,318.26 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,318.26 | $2,570.40 |
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 $1,096.48 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,258.93 | $1,949.84 |
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 $676.08 Median $707.95 Typical High $724.44 | Professional | 52 · Reduced service | $676.08 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $288.40 | Professional | 53 · Discontinued | $269.15 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,023.29 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $144.54 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $954.99 | $1,000.00 | $1,000.00 |
Where Delaware sits
The same service costs 19.5 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· 43rd of 51
$1,413
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.