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 $354.81 Median $602.56 Typical High $7,244.36 | Facility | None | $354.81 | $602.56 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $602.56 | Professional | None | $354.81 | $398.11 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,479.11 Typical High $2,290.87 | Facility | None | $602.56 | $1,479.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $707.95 | Professional | None | $288.40 | $426.58 | $707.95 |
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 $263.03 Median $398.11 Typical High $645.65 | Professional | None | $263.03 | $398.11 | $645.65 |
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 $177.83 Median $190.55 Typical High $302.00 | Professional | 52 · Reduced service | $177.83 | $190.55 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $75.86 Typical High $120.23 | Professional | 53 · Discontinued | $70.79 | $75.86 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $281.84 Typical High $446.68 | Professional | 54 · Surgery only | $263.03 | $281.84 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $89.13 | Professional | 55 · Aftercare only | $53.70 | $56.23 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $60.26 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $263.03 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $245.47 | $263.03 | $416.87 |
Where Delaware sits
The same service costs 4.7 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· 47th of 51
$427
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.