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 $1,096.48 Median $1,096.48 Typical High $7,244.36 | Facility | None | $1,096.48 | $1,096.48 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,000.00 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $5,128.61 Typical High $9,120.11 | Facility | None | $676.08 | $5,128.61 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,737.80 | Professional | None | $912.01 | $912.01 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $5,011.87 | Facility | None | $1,584.89 | $2,818.38 | $5,011.87 |
United Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,479.11 | Professional | None | $812.83 | $933.25 | $1,479.11 |
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 $501.19 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $501.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $204.17 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $758.58 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $776.25 |
Where Delaware sits
The same service costs 13.8 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· 44th of 51
$1,047
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.