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 $69.18 Median $97.72 Typical High $7,244.36 | Facility | None | $69.18 | $97.72 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $97.72 | Professional | None | $67.61 | $72.44 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $107.15 Typical High $154.88 | Facility | None | $58.88 | $107.15 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $131.83 | Professional | None | $57.54 | $83.18 | $131.83 |
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 $53.70 Median $74.13 Typical High $112.20 | Professional | None | $53.70 | $74.13 | $112.20 |
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 $33.88 Median $36.31 Typical High $48.98 | Professional | 52 · Reduced service | $33.88 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.45 Typical High $19.95 | Professional | 53 · Discontinued | $13.49 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $53.70 Typical High $74.13 | Professional | 54 · Surgery only | $50.12 | $53.70 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.72 Typical High $14.79 | Professional | 55 · Aftercare only | $10.00 | $10.72 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.24 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.76 | $7.24 | $9.77 |
Where Delaware sits
The same service costs 3.8 times more in Alaska than in Florida. 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
$81.28
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.