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 $309.03 Median $331.13 Typical High $7,244.36 | Facility | None | $309.03 | $331.13 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $446.68 | Professional | None | $275.42 | $316.23 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $234.42 Typical High $588.84 | Facility | None | $147.91 | $234.42 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $549.54 | Professional | None | $257.04 | $288.40 | $549.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Facility | None | $1,230.27 | $1,230.27 | $1,445.44 |
Highmark BCBS Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $562.34 | Professional | None | $346.74 | $457.09 | $562.34 |
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 $234.42 Median $269.15 Typical High $407.38 | Professional | None | $234.42 | $269.15 | $407.38 |
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 $144.54 Median $154.88 Typical High $165.96 | Professional | 52 · Reduced service | $144.54 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $61.66 Typical High $66.07 | Professional | 53 · Discontinued | $57.54 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $229.09 Typical High $251.19 | Professional | 54 · Surgery only | $218.78 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $46.77 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.90 Typical High $33.11 | Professional | 56 · Pre-op care only | $28.84 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $213.80 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $204.17 | $213.80 | $234.42 |
Where Delaware sits
The same service costs 5.8 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· 48th of 51
$288
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.