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 $1,479.11 Median $4,897.79 Typical High $7,244.36 | Facility | None | $1,479.11 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,073.80 Typical High $7,244.36 | Facility | None | $707.95 | $4,073.80 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $2,630.27 | Professional | None | $891.25 | $891.25 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $3,388.44 | Facility | None | $1,023.29 | $1,819.70 | $3,388.44 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,230.27 Typical High $1,819.70 | Professional | None | $724.44 | $1,230.27 | $1,819.70 |
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 $660.69 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $660.69 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $269.15 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,023.29 |
Where Delaware sits
The same service costs 8.9 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
$1,288
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.