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 $354.81 Median $389.05 Typical High $7,244.36 | Facility | None | $354.81 | $389.05 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $512.86 | Professional | None | $323.59 | $371.54 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $234.42 Typical High $616.60 | Facility | None | $147.91 | $234.42 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $645.65 | Professional | None | $302.00 | $338.84 | $645.65 |
Highmark BCBS Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $3,019.95 | Professional | None | $436.52 | $436.52 | $3,019.95 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $478.63 | Professional | None | $275.42 | $323.59 | $478.63 |
7 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 $169.82 Median $181.97 Typical High $194.98 | Professional | 52 · Reduced service | $169.82 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $72.44 Typical High $77.62 | Professional | 53 · Discontinued | $67.61 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $269.15 Typical High $295.12 | Professional | 54 · Surgery only | $257.04 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $53.70 Typical High $58.88 | Professional | 55 · Aftercare only | $51.29 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $36.31 Typical High $38.90 | Professional | 56 · Pre-op care only | $33.88 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $251.19 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $239.88 | $251.19 | $275.42 |
Highmark BCBS Setting Facility Modifier 55 · Aftercare only Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | 55 · Aftercare only | $501.19 | $501.19 | $501.19 |
Where Delaware sits
The same service costs 5.1 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· 48th of 51
$339
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.