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 $1,000.00 Median $7,244.36 Typical High $7,585.78 | Facility | None | $1,000.00 | $7,244.36 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,047.13 | Professional | None | $977.24 | $1,000.00 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $3,801.89 Typical High $5,888.44 | Facility | None | $676.08 | $3,801.89 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,819.70 | Professional | None | $891.25 | $891.25 | $1,819.70 |
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 $758.58 Median $891.25 Typical High $1,380.38 | Professional | None | $758.58 | $891.25 | $1,380.38 |
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 $489.78 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $489.78 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $194.98 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $724.44 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $707.95 |
Where Delaware sits
The same service costs 18.2 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
$977
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.