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 $389.05 Median $4,897.79 Typical High $7,244.36 | Facility | None | $389.05 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $398.11 | Professional | None | $363.08 | $389.05 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $4,073.80 Typical High $7,244.36 | Facility | None | $660.69 | $4,073.80 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $691.83 | Professional | None | $338.84 | $338.84 | $691.83 |
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 $288.40 Median $346.74 Typical High $630.96 | Professional | None | $288.40 | $346.74 | $630.96 |
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 $181.97 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $181.97 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $72.44 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $288.40 Typical High $295.12 | Professional | 54 · Surgery only | $269.15 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $57.54 Typical High $58.88 | Professional | 55 · Aftercare only | $53.70 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $36.31 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $269.15 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $251.19 | $269.15 | $275.42 |
Where Delaware sits
The same service costs 7.2 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
$389
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.