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 $588.84 Median $4,897.79 Typical High $7,244.36 | Facility | None | $588.84 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $602.56 | Professional | None | $549.54 | $588.84 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,089.30 Typical High $3,235.94 | Facility | None | $707.95 | $2,089.30 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,047.13 | Professional | None | $512.86 | $512.86 | $1,047.13 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $794.33 | Professional | None | $436.52 | $501.19 | $794.33 |
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 $275.42 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $275.42 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $109.65 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $416.87 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $389.05 | $407.38 | $407.38 |
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· 44th of 51
$589
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.