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 $309.03 Median $812.83 Typical High $7,244.36 | Facility | None | $309.03 | $812.83 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $691.83 | Professional | None | $302.00 | $436.52 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,479.11 | Facility | None | $562.34 | $1,000.00 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $616.60 | Professional | None | $316.23 | $426.58 | $616.60 |
Highmark BCBS Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $6,456.54 | Facility | None | $776.25 | $776.25 | $6,456.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | None | $549.54 | $676.08 | $676.08 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $616.60 | Professional | None | $263.03 | $389.05 | $616.60 |
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 $151.36 Median $173.78 Typical High $229.09 | Professional | 52 · Reduced service | $151.36 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $93.33 | Professional | 53 · Discontinued | $60.26 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $257.04 Typical High $346.74 | Professional | 54 · Surgery only | $229.09 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $69.18 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $34.67 Typical High $46.77 | Professional | 56 · Pre-op care only | $30.20 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $239.88 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $213.80 | $239.88 | $323.59 |
Where Delaware sits
The same service costs 4.9 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· 43rd of 51
$417
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.