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 $208.93 Median $218.78 Typical High $7,244.36 | Facility | None | $208.93 | $218.78 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $426.58 | Professional | None | $186.21 | $213.80 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $181.97 Typical High $269.15 | Facility | None | $58.88 | $181.97 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $371.54 | Professional | None | $173.78 | $194.98 | $371.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Highmark BCBS Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $407.38 | Professional | None | $229.09 | $295.12 | $407.38 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $275.42 | Professional | None | $158.49 | $181.97 | $275.42 |
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 $97.72 Median $104.71 Typical High $109.65 | Professional | 52 · Reduced service | $97.72 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $41.69 Typical High $44.67 | Professional | 53 · Discontinued | $38.90 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $154.88 Typical High $165.96 | Professional | 54 · Surgery only | $144.54 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.90 Typical High $33.11 | Professional | 55 · Aftercare only | $28.84 | $30.90 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.89 Typical High $21.88 | Professional | 56 · Pre-op care only | $19.50 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $144.54 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $134.90 | $144.54 | $154.88 |
Where Delaware sits
The same service costs 5.1 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· 48th of 51
$200
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.