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 $107.15 Median $181.97 Typical High $7,244.36 | Facility | None | $107.15 | $181.97 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $181.97 | Professional | None | $107.15 | $177.83 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $173.78 Typical High $251.19 | Facility | None | $58.88 | $173.78 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $281.84 | Professional | None | $97.72 | $165.96 | $281.84 |
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 $97.72 Median $154.88 Typical High $257.04 | Professional | None | $97.72 | $154.88 | $257.04 |
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 $52.48 Median $58.88 Typical High $91.20 | Professional | 52 · Reduced service | $52.48 | $58.88 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $23.44 Typical High $36.31 | Professional | 53 · Discontinued | $21.38 | $23.44 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $87.10 Typical High $138.04 | Professional | 54 · Surgery only | $79.43 | $87.10 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $17.38 Typical High $27.54 | Professional | 55 · Aftercare only | $15.85 | $17.38 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $11.75 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.72 | $11.75 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $81.28 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $74.13 | $81.28 | $128.82 |
Where Delaware sits
The same service costs 4.5 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· 44th of 51
$162
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.