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 $1,412.54 Median $4,897.79 Typical High $7,244.36 | Facility | None | $1,412.54 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,230.27 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,073.80 Typical High $7,244.36 | Facility | None | $707.95 | $4,073.80 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,318.26 | $2,454.71 |
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 $1,047.13 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,230.27 | $1,905.46 |
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 $660.69 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $660.69 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $269.15 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $933.25 | $1,000.00 | $1,000.00 |
Where Delaware sits
The same service costs 17.0 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· 45th of 51
$1,349
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.