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 $316.23 Median $338.84 Typical High $7,244.36 | Facility | None | $316.23 | $338.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $602.56 | Professional | None | $288.40 | $323.59 | $602.56 |
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 $269.15 Median $302.00 Typical High $562.34 | Professional | None | $269.15 | $302.00 | $562.34 |
Highmark BCBS Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $2,511.89 | Professional | None | $354.81 | $501.19 | $2,511.89 |
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 $245.47 Median $281.84 Typical High $426.58 | Professional | None | $245.47 | $281.84 | $426.58 |
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 $147.91 Median $154.88 Typical High $169.82 | Professional | 52 · Reduced service | $147.91 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $63.10 Typical High $67.61 | Professional | 53 · Discontinued | $58.88 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $234.42 Typical High $257.04 | Professional | 54 · Surgery only | $223.87 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $46.77 Typical High $51.29 | Professional | 55 · Aftercare only | $44.67 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $33.88 | Professional | 56 · Pre-op care only | $29.51 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $218.78 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $208.93 | $218.78 | $239.88 |
Where Delaware sits
The same service costs 5.9 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· 47th of 51
$302
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.