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 $575.44 Median $4,073.80 Typical High $7,244.36 | Facility | None | $575.44 | $4,073.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $588.84 | Professional | None | $537.03 | $575.44 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,511.89 Typical High $4,570.88 | Facility | None | $616.60 | $2,511.89 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $1,000.00 | Professional | None | $501.19 | $501.19 | $1,000.00 |
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 $426.58 Median $501.19 Typical High $758.58 | Professional | None | $426.58 | $501.19 | $758.58 |
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 $269.15 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $269.15 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $107.15 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $407.38 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $81.28 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $380.19 | $398.11 | $398.11 |
Where Delaware sits
The same service costs 7.9 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
$562
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.