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 $173.78 Median $275.42 Typical High $7,244.36 | Facility | None | $173.78 | $275.42 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $275.42 | Professional | None | $173.78 | $204.17 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $933.25 Typical High $1,445.44 | Facility | None | $416.87 | $933.25 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $338.84 | Professional | None | $162.18 | $239.88 | $338.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
United Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,698.24 | Facility | None | $229.09 | $398.11 | $1,698.24 |
United Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $354.81 | Professional | None | $147.91 | $218.78 | $354.81 |
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 $87.10 Median $97.72 Typical High $138.04 | Professional | 52 · Reduced service | $87.10 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $38.90 Typical High $56.23 | Professional | 53 · Discontinued | $34.67 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $144.54 Typical High $208.93 | Professional | 54 · Surgery only | $128.82 | $144.54 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $29.51 Typical High $41.69 | Professional | 55 · Aftercare only | $26.30 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.50 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.38 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $134.90 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $120.23 | $134.90 | $194.98 |
Where Delaware sits
The same service costs 4.1 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
$234
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.