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 $158.49 Median $269.15 Typical High $7,244.36 | Facility | None | $158.49 | $269.15 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $302.00 | Professional | None | $158.49 | $251.19 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $208.93 Typical High $302.00 | Facility | None | $58.88 | $208.93 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $338.84 | Professional | None | $151.36 | $239.88 | $338.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | None | $5,370.32 | $5,370.32 | $5,370.32 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $131.83 Median $213.80 Typical High $323.59 | Professional | None | $131.83 | $213.80 | $323.59 |
5 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 $79.43 Median $85.11 Typical High $134.90 | Professional | 52 · Reduced service | $79.43 | $85.11 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $34.67 Typical High $53.70 | Professional | 53 · Discontinued | $31.62 | $34.67 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $128.82 Typical High $204.17 | Professional | 54 · Surgery only | $117.49 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $25.70 Typical High $40.74 | Professional | 55 · Aftercare only | $23.44 | $25.70 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $17.38 Typical High $26.92 | Professional | 56 · Pre-op care only | $15.85 | $17.38 | $26.92 |
Where Delaware sits
The same service costs 3.6 times more in Alaska than in Maryland. 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
$214
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.