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 $158.49 Median $263.03 Typical High $7,244.36 | Facility | None | $158.49 | $263.03 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $263.03 | Professional | None | $158.49 | $218.78 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $302.00 Typical High $588.84 | Facility | None | $204.17 | $302.00 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $346.74 | Professional | None | $151.36 | $223.87 | $346.74 |
United Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,698.24 | Facility | None | $229.09 | $398.11 | $1,698.24 |
United Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $331.13 | Professional | None | $134.90 | $204.17 | $331.13 |
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 $77.62 Median $87.10 Typical High $131.83 | Professional | 52 · Reduced service | $77.62 | $87.10 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $35.48 Typical High $52.48 | Professional | 53 · Discontinued | $31.62 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $131.83 Typical High $194.98 | Professional | 54 · Surgery only | $117.49 | $131.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.30 Typical High $39.81 | Professional | 55 · Aftercare only | $23.44 | $26.30 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $17.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.49 | $17.38 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $123.03 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $109.65 | $123.03 | $181.97 |
Where Delaware sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 42nd of 51
$219
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.