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 $691.83 Median $3,235.94 Typical High $7,244.36 | Facility | None | $691.83 | $3,235.94 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $724.44 | Professional | None | $645.65 | $691.83 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $1,122.02 Typical High $1,698.24 | Facility | None | $467.74 | $1,122.02 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $630.96 Typical High $1,202.26 | Professional | None | $616.60 | $630.96 | $1,202.26 |
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 $524.81 Median $616.60 Typical High $954.99 | Professional | None | $524.81 | $616.60 | $954.99 |
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 $338.84 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $134.90 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $501.19 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $489.78 |
Where Delaware sits
The same service costs 8.5 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
$631
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.