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 $616.60 Median $831.76 Typical High $7,244.36 | Facility | None | $616.60 | $831.76 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $851.14 | Professional | None | $616.60 | $707.95 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,311.31 Typical High $5,888.44 | Facility | None | $954.99 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,148.15 | Professional | None | $602.56 | $758.58 | $1,148.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $12,882.50 | Facility | None | $12,882.50 | $12,882.50 | $12,882.50 |
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 $512.86 Median $676.08 Typical High $1,096.48 | Professional | None | $512.86 | $676.08 | $1,096.48 |
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 $309.03 Median $331.13 Typical High $416.87 | Professional | 52 · Reduced service | $309.03 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $131.83 Typical High $165.96 | Professional | 53 · Discontinued | $123.03 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $616.60 | Professional | 54 · Surgery only | $457.09 | $501.19 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $123.03 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $83.18 | Professional | 56 · Pre-op care only | $61.66 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $575.44 |
Where Delaware sits
The same service costs 6.2 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
$724
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.