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 $1,445.44 Median $6,606.93 Typical High $7,244.36 | Facility | None | $1,445.44 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,288.25 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $1,288.25 Typical High $2,344.23 | Facility | None | $933.25 | $1,288.25 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,258.93 | $2,398.83 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,778.28 | Professional | None | $977.24 | $1,202.26 | $1,778.28 |
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 $645.65 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $645.65 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $954.99 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $190.55 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $891.25 | $1,023.29 | $1,023.29 |
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· 46th of 51
$1,259
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.