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 $1,380.38 Median $1,380.38 Typical High $7,244.36 | Facility | None | $1,380.38 | $1,380.38 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,288.25 | $1,380.38 | $1,380.38 |
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 $1,148.15 Median $1,148.15 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,148.15 | $2,344.23 |
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 $1,047.13 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,174.90 | $1,862.09 |
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 $660.69 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $660.69 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $263.03 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $954.99 |
Where Delaware sits
The same service costs 17.0 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· 45th of 51
$1,318
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.