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 $478.63 Median $660.69 Typical High $7,244.36 | Facility | None | $478.63 | $660.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $660.69 | Professional | None | $478.63 | $549.54 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,137.96 Typical High $3,235.94 | Facility | None | $794.33 | $2,137.96 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $954.99 | Professional | None | $512.86 | $645.65 | $954.99 |
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 $416.87 Median $562.34 Typical High $912.01 | Professional | None | $416.87 | $562.34 | $912.01 |
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 $239.88 Median $275.42 Typical High $331.13 | Professional | 52 · Reduced service | $239.88 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $109.65 Typical High $131.83 | Professional | 53 · Discontinued | $95.50 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $416.87 Typical High $489.78 | Professional | 54 · Surgery only | $354.81 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $72.44 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $66.07 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $389.05 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $331.13 | $389.05 | $457.09 |
Where Delaware sits
The same service costs 5.8 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· 42nd of 51
$617
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.