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 $1,698.24 Median $6,606.93 Typical High $7,244.36 | Facility | None | $1,698.24 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,698.24 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $5,888.44 Typical High $9,120.11 | Facility | None | $676.08 | $5,888.44 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,621.81 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $5,011.87 | Facility | None | $1,584.89 | $2,818.38 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,548.82 | $2,344.23 |
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 $831.76 Median $851.14 Typical High $891.25 | Professional | 52 · Reduced service | $831.76 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $354.81 | Professional | 53 · Discontinued | $331.13 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,258.93 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,230.27 | $1,258.93 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $257.04 Typical High $263.03 | Professional | 55 · Aftercare only | $245.47 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $177.83 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,174.90 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,174.90 | $1,230.27 |
Where Delaware sits
The same service costs 9.3 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· 44th of 51
$1,698
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.