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 $812.83 Median $1,000.00 Typical High $7,244.36 | Facility | None | $812.83 | $1,000.00 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,000.00 | Professional | None | $707.95 | $851.14 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $891.25 Typical High $1,318.26 | Facility | None | $616.60 | $891.25 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $1,258.93 | Professional | None | $512.86 | $575.44 | $1,258.93 |
Highmark BCBS Setting Facility Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $14,125.38 | Facility | None | $14,125.38 | $14,125.38 | $14,125.38 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $977.24 | Professional | None | $457.09 | $602.56 | $977.24 |
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 $363.08 Median $426.58 Typical High $501.19 | Professional | 52 · Reduced service | $363.08 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $199.53 | Professional | 53 · Discontinued | $144.54 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $630.96 Typical High $758.58 | Professional | 54 · Surgery only | $549.54 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $125.89 Typical High $151.36 | Professional | 55 · Aftercare only | $109.65 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $85.11 Typical High $100.00 | Professional | 56 · Pre-op care only | $72.44 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $588.84 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $512.86 | $588.84 | $707.95 |
Where Delaware sits
The same service costs 5.5 times more in Alaska than in Kentucky. 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
$692
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.