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 $1,621.81 Median $7,244.36 Typical High $7,585.78 | Facility | None | $1,621.81 | $7,244.36 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,479.11 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $5,623.41 Typical High $10,000.00 | Facility | None | $1,380.38 | $5,623.41 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,412.54 | $1,479.11 | $2,884.03 |
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 $1,258.93 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,412.54 | $2,187.76 |
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 $758.58 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $758.58 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $309.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,148.15 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $229.09 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,122.02 | $1,122.02 |
Where Delaware sits
The same service costs 20.0 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· 46th of 51
$1,549
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.