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 $1,621.81 Median $7,079.46 Typical High $7,244.36 | Facility | None | $1,621.81 | $7,079.46 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $1,698.24 | Professional | None | $1,445.44 | $1,621.81 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $12,022.64 Typical High $18,620.87 | Facility | None | $676.08 | $12,022.64 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,513.56 Typical High $2,951.21 | Professional | None | $1,445.44 | $1,513.56 | $2,951.21 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $5,128.61 Typical High $10,000.00 | Facility | None | $3,019.95 | $5,128.61 | $10,000.00 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,479.11 | $2,238.72 |
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 $794.33 Median $812.83 Typical High $831.76 | Professional | 52 · Reduced service | $794.33 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $323.59 Typical High $338.84 | Professional | 53 · Discontinued | $316.23 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,230.27 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,202.26 | $1,230.27 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $245.47 Typical High $251.19 | Professional | 55 · Aftercare only | $239.88 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $162.18 Typical High $169.82 | Professional | 56 · Pre-op care only | $158.49 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,148.15 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,148.15 | $1,174.90 |
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· 45th of 51
$1,622
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.