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 $870.96 Median $4,897.79 Typical High $7,244.36 | Facility | None | $870.96 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $891.25 | Professional | None | $794.33 | $870.96 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,073.80 Typical High $7,244.36 | Facility | None | $707.95 | $4,073.80 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $1,513.56 | Professional | None | $758.58 | $776.25 | $1,513.56 |
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 $676.08 Median $776.25 Typical High $1,230.27 | Professional | None | $676.08 | $776.25 | $1,230.27 |
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 $416.87 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $165.96 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $630.96 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $125.89 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $588.84 | $602.56 | $602.56 |
Where Delaware sits
The same service costs 8.1 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
$871
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.