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 $144.54 Median $165.96 Typical High $7,244.36 | Facility | None | $144.54 | $165.96 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $213.80 | Professional | None | $138.04 | $154.88 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $158.49 Typical High $234.42 | Facility | None | $58.88 | $158.49 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $257.04 | Professional | None | $131.83 | $141.25 | $257.04 |
Highmark BCBS Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Highmark BCBS Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
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 $117.49 Median $138.04 Typical High $208.93 | Professional | None | $117.49 | $138.04 | $208.93 |
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 $70.79 Median $74.13 Typical High $83.18 | Professional | 52 · Reduced service | $70.79 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $29.51 Typical High $33.11 | Professional | 53 · Discontinued | $28.18 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $109.65 Typical High $123.03 | Professional | 54 · Surgery only | $107.15 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $24.55 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.79 Typical High $16.60 | Professional | 56 · Pre-op care only | $14.13 | $14.79 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $102.33 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $100.00 | $102.33 | $114.82 |
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· 46th of 51
$141
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.