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 $954.99 Median $6,606.93 Typical High $7,244.36 | Facility | None | $954.99 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $977.24 | Professional | None | $912.01 | $954.99 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $5,128.61 Typical High $9,120.11 | Facility | None | $1,000.00 | $5,128.61 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,698.24 | Professional | None | $831.76 | $912.01 | $1,698.24 |
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 $741.31 Median $851.14 Typical High $1,348.96 | Professional | None | $741.31 | $851.14 | $1,348.96 |
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 $457.09 Median $478.63 Typical High $489.78 | Professional | 52 · Reduced service | $457.09 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $190.55 Typical High $194.98 | Professional | 53 · Discontinued | $181.97 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $707.95 Typical High $741.31 | Professional | 54 · Surgery only | $691.83 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $138.04 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $97.72 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $645.65 | $660.69 | $691.83 |
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
$955
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.