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 $53.70 Median $158.49 Typical High $3,235.94 | Facility | None | $53.70 | $158.49 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $107.15 Typical High $288.40 | Professional | None | $53.70 | $107.15 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $85.11 Typical High $151.36 | Facility | None | $56.23 | $85.11 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $194.98 | Professional | None | $69.18 | $144.54 | $194.98 |
Highmark BCBS Setting Facility Modifier None Typical Low $190.55 Median $1,023.29 Typical High $8,709.64 | Facility | None | $190.55 | $1,023.29 | $8,709.64 |
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 $100.00 Typical High $165.96 | Professional | None | $53.70 | $100.00 | $165.96 |
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 $26.92 Median $30.20 Typical High $79.43 | Professional | 52 · Reduced service | $26.92 | $30.20 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $12.02 Typical High $31.62 | Professional | 53 · Discontinued | $10.96 | $12.02 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $44.67 Typical High $117.49 | Professional | 54 · Surgery only | $40.74 | $44.67 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.91 Typical High $23.44 | Professional | 55 · Aftercare only | $8.13 | $8.91 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.03 Typical High $15.85 | Professional | 56 · Pre-op care only | $5.37 | $6.03 | $15.85 |
Where Delaware sits
The same service costs 4.0 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· 35th of 51
$117
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.