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 $1,047.13 Median $2,691.53 Typical High $7,244.36 | Facility | None | $1,047.13 | $2,691.53 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,071.52 | Professional | None | $977.24 | $1,047.13 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,311.31 Typical High $5,888.44 | Facility | None | $676.08 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,862.09 | Professional | None | $891.25 | $1,071.52 | $1,862.09 |
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 $891.25 Median $1,000.00 Typical High $1,513.56 | Professional | None | $891.25 | $1,000.00 | $1,513.56 |
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 $501.19 Median $512.86 Typical High $537.03 | Professional | 52 · Reduced service | $501.19 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $208.93 Typical High $213.80 | Professional | 53 · Discontinued | $199.53 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $776.25 Typical High $794.33 | Professional | 54 · Surgery only | $758.58 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $154.88 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $104.71 Typical High $107.15 | Professional | 56 · Pre-op care only | $100.00 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $724.44 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $707.95 | $724.44 | $741.31 |
Where Delaware sits
The same service costs 7.9 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
$1,072
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.