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 $288.40 Median $316.23 Typical High $7,244.36 | Facility | None | $288.40 | $316.23 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $602.56 | Professional | None | $257.04 | $302.00 | $602.56 |
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 $234.42 Median $269.15 Typical High $512.86 | Professional | None | $234.42 | $269.15 | $512.86 |
Highmark BCBS Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Highmark BCBS Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $501.19 | Professional | None | $302.00 | $389.05 | $501.19 |
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 $218.78 Median $257.04 Typical High $380.19 | Professional | None | $218.78 | $257.04 | $380.19 |
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 $134.90 Median $144.54 Typical High $158.49 | Professional | 52 · Reduced service | $134.90 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $63.10 | Professional | 53 · Discontinued | $54.95 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $218.78 Typical High $234.42 | Professional | 54 · Surgery only | $204.17 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $43.65 Typical High $46.77 | Professional | 55 · Aftercare only | $40.74 | $43.65 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $31.62 | Professional | 56 · Pre-op care only | $27.54 | $29.51 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $204.17 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $190.55 | $204.17 | $218.78 |
Where Delaware sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$269
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.