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 $275.42 Median $6,606.93 Typical High $7,244.36 | Facility | None | $275.42 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $275.42 Typical High $616.60 | Professional | None | $263.03 | $275.42 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,096.48 Typical High $2,290.87 | Facility | None | $416.87 | $1,096.48 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $489.78 | Professional | None | $245.47 | $275.42 | $489.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $398.11 | Professional | None | $229.09 | $257.04 | $398.11 |
5 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 $131.83 Median $134.90 Typical High $141.25 | Professional | 52 · Reduced service | $131.83 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $54.95 Typical High $56.23 | Professional | 53 · Discontinued | $52.48 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $204.17 Typical High $213.80 | Professional | 54 · Surgery only | $199.53 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $40.74 Typical High $42.66 | Professional | 55 · Aftercare only | $39.81 | $40.74 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $27.54 Typical High $28.18 | Professional | 56 · Pre-op care only | $26.30 | $27.54 | $28.18 |
Where Delaware sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 47th of 51
$275
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.