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 $2,137.96 Median $7,079.46 Typical High $7,244.36 | Facility | None | $2,137.96 | $7,079.46 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $2,238.72 | Professional | None | $1,995.26 | $2,137.96 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $11,748.98 Typical High $18,197.01 | Facility | None | $676.08 | $11,748.98 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $3,890.45 | Professional | None | $1,905.46 | $2,089.30 | $3,890.45 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $5,128.61 Typical High $10,000.00 | Facility | None | $3,019.95 | $5,128.61 | $10,000.00 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,737.80 | $1,949.84 | $3,019.95 |
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 $1,047.13 Median $1,071.52 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,047.13 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $426.58 Typical High $446.68 | Professional | 53 · Discontinued | $416.87 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,621.81 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,548.82 | $1,621.81 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $323.59 Typical High $331.13 | Professional | 55 · Aftercare only | $309.03 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $213.80 Typical High $223.87 | Professional | 56 · Pre-op care only | $208.93 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,513.56 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,513.56 | $1,548.82 |
Where Delaware sits
The same service costs 6.5 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· 46th of 51
$2,138
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.