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 $154.88 Median $275.42 Typical High $7,244.36 | Facility | None | $154.88 | $275.42 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $275.42 | Professional | None | $154.88 | $223.87 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $933.25 Typical High $1,445.44 | Facility | None | $416.87 | $933.25 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $316.23 | Professional | None | $147.91 | $234.42 | $316.23 |
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 $128.82 Median $208.93 Typical High $331.13 | Professional | None | $128.82 | $208.93 | $331.13 |
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 $77.62 Median $87.10 Typical High $138.04 | Professional | 52 · Reduced service | $77.62 | $87.10 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $34.67 Typical High $54.95 | Professional | 53 · Discontinued | $30.90 | $34.67 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $128.82 Typical High $204.17 | Professional | 54 · Surgery only | $114.82 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.30 Typical High $40.74 | Professional | 55 · Aftercare only | $23.44 | $26.30 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $17.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.49 | $17.38 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $120.23 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $107.15 | $120.23 | $190.55 |
Where Delaware sits
The same service costs 4.5 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· 43rd of 51
$224
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.