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 $676.08 Median $6,025.60 Typical High $7,244.36 | Facility | None | $676.08 | $6,025.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $724.44 | Professional | None | $645.65 | $676.08 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,311.31 Typical High $5,888.44 | Facility | None | $870.96 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,230.27 | Professional | None | $588.84 | $741.31 | $1,230.27 |
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 $549.54 Median $645.65 Typical High $1,047.13 | Professional | None | $549.54 | $645.65 | $1,047.13 |
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 $323.59 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $323.59 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $141.25 | Professional | 53 · Discontinued | $128.82 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $524.81 | Professional | 54 · Surgery only | $478.63 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $70.79 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $489.78 |
Where Delaware sits
The same service costs 8.1 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· 40th of 51
$741
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.