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 $794.33 Median $6,606.93 Typical High $7,244.36 | Facility | None | $794.33 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $831.76 | Professional | None | $776.25 | $794.33 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $4,073.80 Typical High $7,244.36 | Facility | None | $1,000.00 | $4,073.80 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,445.44 | Professional | None | $707.95 | $741.31 | $1,445.44 |
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 $616.60 Median $724.44 Typical High $1,122.02 | Professional | None | $616.60 | $724.44 | $1,122.02 |
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 $389.05 Median $398.11 Typical High $407.38 | Professional | 52 · Reduced service | $389.05 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $154.88 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $588.84 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $79.43 Typical High $81.28 | Professional | 56 · Pre-op care only | $77.62 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $549.54 | $562.34 | $562.34 |
Where Delaware sits
The same service costs 7.4 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
$794
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.