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 $660.69 Median $6,025.60 Typical High $7,244.36 | Facility | None | $660.69 | $6,025.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $1,000.00 | Professional | None | $616.60 | $660.69 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $4,073.80 Typical High $7,244.36 | Facility | None | $676.08 | $4,073.80 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $1,202.26 | Professional | None | $588.84 | $616.60 | $1,202.26 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $5,888.44 Typical High $10,471.29 | Facility | None | $5,128.61 | $5,888.44 | $10,471.29 |
Highmark BCBS Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,754.40 | Professional | None | $5,495.41 | $5,495.41 | $5,754.40 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $3,388.44 | Facility | None | $1,023.29 | $1,819.70 | $3,388.44 |
United Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $912.01 | Professional | None | $501.19 | $602.56 | $912.01 |
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 $323.59 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $323.59 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $489.78 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $67.61 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $457.09 | $467.74 | $467.74 |
Where Delaware sits
The same service costs 8.1 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· 46th of 51
$661
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.