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 $263.03 Median $295.12 Typical High $7,244.36 | Facility | None | $263.03 | $295.12 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $478.63 | Professional | None | $229.09 | $275.42 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $181.97 Typical High $269.15 | Facility | None | $58.88 | $181.97 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $457.09 | Professional | None | $204.17 | $239.88 | $457.09 |
Highmark BCBS Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $346.74 | Professional | None | $194.98 | $239.88 | $346.74 |
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 $125.89 Median $131.83 Typical High $147.91 | Professional | 52 · Reduced service | $125.89 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $53.70 Typical High $58.88 | Professional | 53 · Discontinued | $51.29 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $199.53 Typical High $223.87 | Professional | 54 · Surgery only | $190.55 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $39.81 Typical High $44.67 | Professional | 55 · Aftercare only | $38.02 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.92 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.12 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $186.21 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $177.83 | $186.21 | $208.93 |
Where Delaware sits
The same service costs 5.4 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· 48th of 51
$245
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.