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 $66.07 Median $199.53 Typical High $7,244.36 | Facility | None | $66.07 | $199.53 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $147.91 Typical High $204.17 | Professional | None | $60.26 | $147.91 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $281.84 | Professional | None | $66.07 | $154.88 | $281.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $346.74 | Facility | None | $70.79 | $70.79 | $346.74 |
Highmark BCBS Setting Professional Modifier None Typical Low $61.66 Median $173.78 Typical High $588.84 | Professional | None | $61.66 | $173.78 | $588.84 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $60.26 Median $151.36 Typical High $398.11 | Professional | None | $60.26 | $151.36 | $398.11 |
5 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 $32.36 Median $52.48 Typical High $100.00 | Professional | 52 · Reduced service | $32.36 | $52.48 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $20.89 Typical High $39.81 | Professional | 53 · Discontinued | $13.18 | $20.89 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $79.43 Typical High $147.91 | Professional | 54 · Surgery only | $48.98 | $79.43 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $15.85 Typical High $29.51 | Professional | 55 · Aftercare only | $9.77 | $15.85 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.47 Typical High $19.95 | Professional | 56 · Pre-op care only | $6.61 | $10.47 | $19.95 |
Where Delaware sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 36th of 51
$148
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.