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 $724.44 Median $6,606.93 Typical High $7,244.36 | Facility | None | $724.44 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,096.48 | Professional | None | $676.08 | $724.44 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,630.27 Typical High $4,073.80 | Facility | None | $676.08 | $2,630.27 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $1,288.25 | Professional | None | $645.65 | $691.83 | $1,288.25 |
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 $537.03 Median $645.65 Typical High $977.24 | Professional | None | $537.03 | $645.65 | $977.24 |
7 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 $346.74 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $346.74 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $524.81 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $104.71 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $489.78 | $501.19 | $501.19 |
Highmark BCBS Setting Facility Modifier 50 · Both sides Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Facility | 50 · Both sides | $4,168.69 | $4,168.69 | $4,168.69 |
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· 43rd 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.