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 $117.49 Median $269.15 Typical High $7,244.36 | Facility | None | $117.49 | $269.15 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $257.04 Typical High $354.81 | Professional | None | $117.49 | $257.04 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $269.15 Typical High $416.87 | Facility | None | $58.88 | $269.15 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $407.38 | Professional | None | $112.20 | $204.17 | $407.38 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
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 $112.20 Median $204.17 Typical High $338.84 | Professional | None | $112.20 | $204.17 | $338.84 |
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 $58.88 Median $64.57 Typical High $134.90 | Professional | 52 · Reduced service | $58.88 | $64.57 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.30 Typical High $53.70 | Professional | 53 · Discontinued | $23.44 | $26.30 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $97.72 Typical High $204.17 | Professional | 54 · Surgery only | $89.13 | $97.72 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.50 Typical High $40.74 | Professional | 55 · Aftercare only | $17.78 | $19.50 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $11.75 | $12.88 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $91.20 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $83.18 | $91.20 | $190.55 |
Where Delaware sits
The same service costs 3.9 times more in Alaska 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· 43rd of 51
$204
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.