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 $831.76 Median $4,073.80 Typical High $7,244.36 | Facility | None | $831.76 | $4,073.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $870.96 | Professional | None | $741.31 | $831.76 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,862.09 Typical High $3,235.94 | Facility | None | $616.60 | $1,862.09 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,348.96 | Professional | None | $676.08 | $676.08 | $1,348.96 |
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 $575.44 Median $691.83 Typical High $1,047.13 | Professional | None | $575.44 | $691.83 | $1,047.13 |
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 $371.54 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $371.54 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $562.34 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $74.13 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $588.84 |
Where Delaware sits
The same service costs 8.3 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
$724
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.