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 $549.54 Median $4,897.79 Typical High $9,549.93 | Facility | None | $549.54 | $4,897.79 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $562.34 | Professional | None | $512.86 | $549.54 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,089.30 Typical High $3,235.94 | Facility | None | $707.95 | $2,089.30 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $954.99 | Professional | None | $478.63 | $478.63 | $954.99 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $5,011.87 | Facility | None | $1,584.89 | $2,818.38 | $5,011.87 |
United Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $724.44 | Professional | None | $398.11 | $478.63 | $724.44 |
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 $257.04 Median $269.15 Typical High $275.42 | Professional | 52 · Reduced service | $257.04 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $102.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $380.19 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $75.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $354.81 | $380.19 | $380.19 |
Where Delaware sits
The same service costs 7.9 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· 43rd of 51
$550
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.