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 $1,174.90 Median $6,025.60 Typical High $7,244.36 | Facility | None | $1,174.90 | $6,025.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,174.90 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $5,623.41 Typical High $10,000.00 | Facility | None | $870.96 | $5,623.41 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,230.27 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $5,011.87 | Facility | None | $1,584.89 | $2,818.38 | $5,011.87 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,778.28 | Professional | None | $954.99 | $1,122.02 | $1,778.28 |
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 $562.34 Median $588.84 Typical High $602.56 | Professional | 52 · Reduced service | $562.34 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $234.42 Typical High $239.88 | Professional | 53 · Discontinued | $229.09 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $870.96 Typical High $912.01 | Professional | 54 · Surgery only | $851.14 | $870.96 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $173.78 Typical High $181.97 | Professional | 55 · Aftercare only | $169.82 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $120.23 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $812.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $794.33 | $812.83 | $851.14 |
Where Delaware sits
The same service costs 8.3 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
$1,230
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.