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 $831.76 Median $6,025.60 Typical High $7,244.36 | Facility | None | $831.76 | $6,025.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $870.96 | Professional | None | $812.83 | $831.76 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $4,073.80 Typical High $7,244.36 | Facility | None | $870.96 | $4,073.80 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $1,479.11 | Professional | None | $741.31 | $758.58 | $1,479.11 |
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 $630.96 Median $724.44 Typical High $1,122.02 | Professional | None | $630.96 | $724.44 | $1,122.02 |
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 $407.38 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $407.38 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $162.18 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $602.56 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $120.23 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $81.28 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $562.34 | $588.84 | $588.84 |
Where Delaware sits
The same service costs 7.6 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· 46th of 51
$832
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.