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 $707.95 Median $707.95 Typical High $7,244.36 | Facility | None | $707.95 | $707.95 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $707.95 Typical High $741.31 | Professional | None | $691.83 | $707.95 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,677.35 Typical High $7,244.36 | Facility | None | $676.08 | $4,677.35 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $741.31 Typical High $1,258.93 | Professional | None | $660.69 | $741.31 | $1,258.93 |
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 $575.44 Median $676.08 Typical High $1,096.48 | Professional | None | $575.44 | $676.08 | $1,096.48 |
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 $338.84 Median $354.81 Typical High $363.08 | Professional | 52 · Reduced service | $338.84 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $141.25 Typical High $147.91 | Professional | 53 · Discontinued | $138.04 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $524.81 Typical High $549.54 | Professional | 54 · Surgery only | $512.86 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $107.15 Typical High $109.65 | Professional | 55 · Aftercare only | $102.33 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $70.79 Typical High $74.13 | Professional | 56 · Pre-op care only | $69.18 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $489.78 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $478.63 | $489.78 | $512.86 |
Where Delaware sits
The same service costs 8.7 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· 43rd of 51
$741
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.