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 $74.13 Median $104.71 Typical High $7,244.36 | Facility | None | $74.13 | $104.71 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $181.97 | Professional | None | $77.62 | $102.33 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $107.15 Typical High $588.84 | Facility | None | $67.61 | $107.15 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $190.55 | Professional | None | $79.43 | $107.15 | $190.55 |
Highmark BCBS Setting Facility Modifier None Typical Low $275.42 Median $323.59 Typical High $616.60 | Facility | None | $275.42 | $323.59 | $616.60 |
Highmark BCBS Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $66.07 Median $91.20 Typical High $154.88 | Professional | None | $66.07 | $91.20 | $154.88 |
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 $39.81 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $39.81 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $17.78 Typical High $21.38 | Professional | 53 · Discontinued | $15.85 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $66.07 Typical High $79.43 | Professional | 54 · Surgery only | $58.88 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.49 Typical High $15.85 | Professional | 55 · Aftercare only | $11.75 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.94 | $8.91 | $10.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $61.66 Typical High $74.13 | Professional | 78 · Unplanned return to OR | $54.95 | $61.66 | $74.13 |
Where Delaware sits
The same service costs 3.9 times more in Alaska than in Florida. 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· 40th of 51
$102
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.