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 $1,737.80 Median $6,606.93 Typical High $7,244.36 | Facility | None | $1,737.80 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,737.80 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,073.80 Typical High $7,244.36 | Facility | None | $676.08 | $4,073.80 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,348.96 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $5,011.87 | Facility | None | $1,584.89 | $2,818.38 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,479.11 | $2,089.30 |
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 $741.31 Median $870.96 Typical High $891.25 | Professional | 52 · Reduced service | $741.31 | $870.96 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $346.74 Typical High $363.08 | Professional | 53 · Discontinued | $302.00 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,318.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,122.02 | $1,318.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $263.03 Typical High $269.15 | Professional | 55 · Aftercare only | $223.87 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $173.78 Typical High $181.97 | Professional | 56 · Pre-op care only | $151.36 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,230.27 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,230.27 | $1,258.93 |
Where Delaware sits
The same service costs 11.2 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· 45th of 51
$1,622
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.