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 $239.88 Median $245.47 Typical High $7,244.36 | Facility | None | $239.88 | $245.47 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $251.19 | Professional | None | $218.78 | $239.88 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,096.48 Typical High $1,698.24 | Facility | None | $416.87 | $1,096.48 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $407.38 | Professional | None | $199.53 | $199.53 | $407.38 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $316.23 | Professional | None | $173.78 | $199.53 | $316.23 |
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 $109.65 Median $120.23 Typical High $123.03 | Professional | 52 · Reduced service | $109.65 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $43.65 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $181.97 Typical High $186.21 | Professional | 54 · Surgery only | $162.18 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $36.31 Typical High $37.15 | Professional | 55 · Aftercare only | $32.36 | $36.31 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.99 Typical High $24.55 | Professional | 56 · Pre-op care only | $21.88 | $23.99 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $169.82 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $151.36 | $169.82 | $173.78 |
Where Delaware sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 46th of 51
$229
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.