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 $691.83 Median $724.44 Typical High $7,244.36 | Facility | None | $691.83 | $724.44 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $741.31 | Professional | None | $660.69 | $724.44 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,089.30 Typical High $3,235.94 | Facility | None | $707.95 | $2,089.30 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,071.52 | Professional | None | $549.54 | $676.08 | $1,071.52 |
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 $501.19 Median $630.96 Typical High $977.24 | Professional | None | $501.19 | $630.96 | $977.24 |
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 $331.13 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $331.13 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $131.83 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $549.54 | Professional | 54 · Surgery only | $501.19 | $537.03 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $74.13 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $512.86 |
Where Delaware sits
The same service costs 6.6 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· 46th of 51
$676
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.