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 $1,071.52 Median $6,606.93 Typical High $7,244.36 | Facility | None | $1,071.52 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,096.48 | Professional | None | $1,000.00 | $1,071.52 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $10,471.29 Typical High $19,054.61 | Facility | None | $1,000.00 | $10,471.29 | $19,054.61 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,905.46 | Professional | None | $912.01 | $912.01 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $3,981.07 | Facility | None | $1,412.54 | $2,398.83 | $3,981.07 |
United Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,445.44 | Professional | None | $831.76 | $954.99 | $1,445.44 |
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 $512.86 Median $537.03 Typical High $549.54 | Professional | 52 · Reduced service | $512.86 | $537.03 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $218.78 | Professional | 53 · Discontinued | $204.17 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $794.33 Typical High $812.83 | Professional | 54 · Surgery only | $776.25 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $154.88 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $109.65 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $741.31 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $724.44 | $741.31 | $758.58 |
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· 44th of 51
$1,072
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.