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 $1,659.59 Median $4,073.80 Typical High $7,244.36 | Facility | None | $1,659.59 | $4,073.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,479.11 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,089.30 Typical High $3,235.94 | Facility | None | $616.60 | $2,089.30 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,445.44 | $1,479.11 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $3,388.44 | Facility | None | $1,023.29 | $1,819.70 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,412.54 | $2,187.76 |
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 $741.31 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $741.31 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $302.00 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,122.02 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $151.36 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,174.90 | $1,174.90 |
Where Delaware sits
The same service costs 7.8 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· 46th of 51
$1,514
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.