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 $1,202.26 Median $6,606.93 Typical High $7,244.36 | Facility | None | $1,202.26 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,258.93 | Professional | None | $1,122.02 | $1,202.26 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $6,025.60 Typical High $9,332.54 | Facility | None | $676.08 | $6,025.60 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,122.02 | $2,187.76 |
Highmark BCBS Setting Facility Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $12,882.50 | Facility | None | $12,882.50 | $12,882.50 | $12,882.50 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $5,011.87 | Facility | None | $1,584.89 | $2,818.38 | $5,011.87 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,659.59 | Professional | None | $954.99 | $1,096.48 | $1,659.59 |
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 $588.84 Median $602.56 Typical High $616.60 | Professional | 52 · Reduced service | $588.84 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $234.42 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $933.25 | Professional | 54 · Surgery only | $891.25 | $912.01 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $186.21 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $123.03 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $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· 44th of 51
$1,202
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.