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 $275.42 Median $316.23 Typical High $7,244.36 | Facility | None | $275.42 | $316.23 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $363.08 | Professional | None | $275.42 | $309.03 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,174.90 Typical High $1,905.46 | Facility | None | $645.65 | $1,174.90 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $302.00 Typical High $512.86 | Professional | None | $281.84 | $302.00 | $512.86 |
Highmark BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $457.09 | Professional | None | $234.42 | $281.84 | $457.09 |
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 $134.90 Median $141.25 Typical High $158.49 | Professional | 52 · Reduced service | $134.90 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $57.54 Typical High $63.10 | Professional | 53 · Discontinued | $54.95 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $213.80 Typical High $234.42 | Professional | 54 · Surgery only | $204.17 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $42.66 Typical High $46.77 | Professional | 55 · Aftercare only | $40.74 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.84 Typical High $31.62 | Professional | 56 · Pre-op care only | $27.54 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $199.53 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $190.55 | $199.53 | $218.78 |
Where Delaware sits
The same service costs 6.8 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· 44th 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.