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 $912.01 Median $4,897.79 Typical High $7,244.36 | Facility | None | $912.01 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $1,000.00 | Professional | None | $851.14 | $912.01 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $7,413.10 Typical High $13,182.57 | Facility | None | $707.95 | $7,413.10 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,659.59 | Professional | None | $831.76 | $977.24 | $1,659.59 |
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 $758.58 Median $870.96 Typical High $1,445.44 | Professional | None | $758.58 | $870.96 | $1,445.44 |
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 $446.68 Median $457.09 Typical High $478.63 | Professional | 52 · Reduced service | $446.68 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $190.55 | Professional | 53 · Discontinued | $177.83 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $724.44 | Professional | 54 · Surgery only | $676.08 | $691.83 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $144.54 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $95.50 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $676.08 |
Where Delaware sits
The same service costs 7.9 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· 42nd of 51
$977
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.