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 $169.82 Median $288.40 Typical High $7,244.36 | Facility | None | $169.82 | $288.40 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $288.40 | Professional | None | $169.82 | $190.55 | $288.40 |
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 $144.54 Median $204.17 Typical High $346.74 | Professional | None | $144.54 | $204.17 | $346.74 |
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 $138.04 Median $190.55 Typical High $316.23 | Professional | None | $138.04 | $190.55 | $316.23 |
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 $85.11 Median $89.13 Typical High $144.54 | Professional | 52 · Reduced service | $85.11 | $89.13 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $36.31 Typical High $57.54 | Professional | 53 · Discontinued | $33.88 | $36.31 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $134.90 Typical High $218.78 | Professional | 54 · Surgery only | $128.82 | $134.90 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $43.65 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.20 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.98 | $18.20 | $28.84 |
Where Delaware sits
The same service costs 4.0 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· 48th of 51
$200
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.