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 $891.25 Median $4,897.79 Typical High $7,244.36 | Facility | None | $891.25 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $912.01 | Professional | None | $812.83 | $891.25 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,623.41 Typical High $10,000.00 | Facility | None | $707.95 | $5,623.41 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,445.44 | Professional | None | $758.58 | $794.33 | $1,445.44 |
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 $630.96 Median $758.58 Typical High $1,148.15 | Professional | None | $630.96 | $758.58 | $1,148.15 |
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 $416.87 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $416.87 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $165.96 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $616.60 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $616.60 |
Where Delaware sits
The same service costs 7.6 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
$832
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.