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 $158.49 Median $645.65 Typical High $8,128.31 | Facility | None | $158.49 | $645.65 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $380.19 | Professional | None | $158.49 | $245.47 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,071.52 Typical High $1,659.59 | Facility | None | $416.87 | $1,071.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $407.38 | Professional | None | $190.55 | $288.40 | $407.38 |
Highmark BCBS Setting Facility Modifier None Typical Low $758.58 Median $977.24 Typical High $6,760.83 | Facility | None | $758.58 | $977.24 | $6,760.83 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $457.09 | Professional | None | $165.96 | $263.03 | $457.09 |
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 $79.43 Median $87.10 Typical High $123.03 | Professional | 52 · Reduced service | $79.43 | $87.10 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $35.48 Typical High $48.98 | Professional | 53 · Discontinued | $32.36 | $35.48 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $131.83 Typical High $181.97 | Professional | 54 · Surgery only | $120.23 | $131.83 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.30 Typical High $37.15 | Professional | 55 · Aftercare only | $23.99 | $26.30 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $17.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $15.85 | $17.38 | $24.55 |
Where Delaware sits
The same service costs 3.1 times more in Alaska than in New York. 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· 39th of 51
$309
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.