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 $331.13 Median $346.74 Typical High $7,244.36 | Facility | None | $331.13 | $346.74 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $645.65 | Professional | None | $257.04 | $331.13 | $645.65 |
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 $229.09 Median $263.03 Typical High $562.34 | Professional | None | $229.09 | $263.03 | $562.34 |
Highmark BCBS Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $831.76 | Facility | None | $501.19 | $501.19 | $831.76 |
Highmark BCBS Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $2,691.53 | Professional | None | $446.68 | $489.78 | $2,691.53 |
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 $213.80 Median $281.84 Typical High $389.05 | Professional | None | $213.80 | $281.84 | $389.05 |
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 $147.91 Median $165.96 Typical High $173.78 | Professional | 52 · Reduced service | $147.91 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $66.07 Typical High $69.18 | Professional | 53 · Discontinued | $58.88 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $251.19 Typical High $257.04 | Professional | 54 · Surgery only | $223.87 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $50.12 Typical High $52.48 | Professional | 55 · Aftercare only | $44.67 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $33.11 Typical High $34.67 | Professional | 56 · Pre-op care only | $29.51 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $234.42 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $208.93 | $234.42 | $239.88 |
Where Delaware sits
The same service costs 5.6 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
$295
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.