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 $489.78 Median $6,606.93 Typical High $7,244.36 | Facility | None | $489.78 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $512.86 | Professional | None | $467.74 | $489.78 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $3,311.31 Typical High $5,888.44 | Facility | None | $891.25 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $891.25 | Professional | None | $436.52 | $512.86 | $891.25 |
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 $426.58 Median $478.63 Typical High $724.44 | Professional | None | $426.58 | $478.63 | $724.44 |
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 $234.42 Median $239.88 Typical High $251.19 | Professional | 52 · Reduced service | $234.42 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $93.33 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $371.54 | Professional | 54 · Surgery only | $354.81 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $338.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $331.13 | $338.84 | $346.74 |
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
$513
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.