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 $229.09 Median $588.84 Typical High $7,244.36 | Facility | None | $229.09 | $588.84 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $263.03 | Professional | None | $218.78 | $234.42 | $263.03 |
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 $229.09 Median $245.47 Typical High $416.87 | Professional | None | $229.09 | $245.47 | $416.87 |
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 $190.55 Median $229.09 Typical High $346.74 | Professional | None | $190.55 | $229.09 | $346.74 |
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 $112.20 Median $117.49 Typical High $128.82 | Professional | 52 · Reduced service | $112.20 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $45.71 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $173.78 Typical High $194.98 | Professional | 54 · Surgery only | $169.82 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $33.88 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.91 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $162.18 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $158.49 | $162.18 | $181.97 |
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· 47th of 51
$234
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.