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 $1,174.90 Median $6,606.93 Typical High $7,244.36 | Facility | None | $1,174.90 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,174.90 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $5,888.44 Typical High $9,120.11 | Facility | None | $676.08 | $5,888.44 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,174.90 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $3,981.07 | Facility | None | $1,412.54 | $2,398.83 | $3,981.07 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,698.24 | Professional | None | $954.99 | $1,096.48 | $1,698.24 |
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 $575.44 Median $588.84 Typical High $616.60 | Professional | 52 · Reduced service | $575.44 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $239.88 Typical High $245.47 | Professional | 53 · Discontinued | $229.09 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $891.25 Typical High $933.25 | Professional | 54 · Surgery only | $870.96 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $177.83 Typical High $186.21 | Professional | 55 · Aftercare only | $173.78 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $117.49 Typical High $123.03 | Professional | 56 · Pre-op care only | $114.82 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $831.76 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $812.83 | $831.76 | $870.96 |
Where Delaware sits
The same service costs 8.7 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
$1,175
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.