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 $446.68 Median $602.56 Typical High $7,244.36 | Facility | None | $446.68 | $602.56 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $616.60 | Professional | None | $446.68 | $501.19 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $3,311.31 Typical High $5,888.44 | Facility | None | $794.33 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,000.00 | Professional | None | $467.74 | $588.84 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $3,981.07 | Facility | None | $1,412.54 | $2,398.83 | $3,981.07 |
United Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $1,096.48 | Professional | None | $436.52 | $630.96 | $1,096.48 |
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 $223.87 Median $251.19 Typical High $302.00 | Professional | 52 · Reduced service | $223.87 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $100.00 Typical High $120.23 | Professional | 53 · Discontinued | $89.13 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $446.68 | Professional | 54 · Surgery only | $331.13 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $74.13 Typical High $89.13 | Professional | 55 · Aftercare only | $67.61 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $50.12 Typical High $60.26 | Professional | 56 · Pre-op care only | $44.67 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $346.74 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $309.03 | $346.74 | $416.87 |
Where Delaware sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 41st of 51
$646
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.