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 $707.95 Median $6,606.93 Typical High $7,244.36 | Facility | None | $707.95 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $707.95 Typical High $741.31 | Professional | None | $691.83 | $707.95 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,089.30 Typical High $3,235.94 | Facility | None | $1,000.00 | $2,089.30 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $1,288.25 | Professional | None | $630.96 | $660.69 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $3,388.44 | Facility | None | $1,023.29 | $1,819.70 | $3,388.44 |
United Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,000.00 | Professional | None | $549.54 | $645.65 | $1,000.00 |
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 $346.74 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $346.74 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $141.25 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $524.81 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $104.71 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $70.79 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $489.78 | $501.19 | $501.19 |
Where Delaware sits
The same service costs 8.7 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
$708
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.