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 $489.78 Median $524.81 Typical High $7,244.36 | Facility | None | $489.78 | $524.81 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $549.54 | Professional | None | $426.58 | $489.78 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $234.42 Typical High $812.83 | Facility | None | $147.91 | $234.42 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $870.96 | Professional | None | $426.58 | $457.09 | $870.96 |
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 $371.54 Median $436.52 Typical High $660.69 | Professional | None | $371.54 | $436.52 | $660.69 |
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 $229.09 Median $245.47 Typical High $263.03 | Professional | 52 · Reduced service | $229.09 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $104.71 | Professional | 53 · Discontinued | $91.20 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $371.54 Typical High $398.11 | Professional | 54 · Surgery only | $346.74 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $74.13 Typical High $79.43 | Professional | 55 · Aftercare only | $69.18 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $52.48 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $346.74 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $323.59 | $346.74 | $371.54 |
Where Delaware sits
The same service costs 5.8 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· 48th of 51
$457
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.