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 $13.80 Median $15.49 Typical High $85.11 | Facility | None | $13.80 | $15.49 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $20.89 Typical High $85.11 | Professional | None | $15.14 | $20.89 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $8.91 Typical High $41.69 | Professional | 52 · Reduced service | $7.76 | $8.91 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.55 Typical High $16.98 | Professional | 53 · Discontinued | $3.09 | $3.55 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $8.71 Typical High $12.59 | Professional | 55 · Aftercare only | $2.34 | $8.71 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.78 Typical High $8.51 | Professional | 56 · Pre-op care only | $1.55 | $1.78 | $8.51 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $95.50 Typical High $645.65 | Facility | None | $56.23 | $95.50 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $75.86 Typical High $100.00 | Professional | None | $16.98 | $75.86 | $100.00 |
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 $13.80 Median $38.02 Typical High $93.33 | Professional | None | $13.80 | $38.02 | $93.33 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier PN · Off-campus dept, non-excepted Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | PN · Off-campus dept, non-excepted | $346.74 | $346.74 | $346.74 |
Where Delaware sits
The same service costs 5.9 times more in Iowa than in Kentucky. 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· 26th of 51
$70.79
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.