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 $123.03 Median $213.80 Typical High $7,244.36 | Facility | None | $123.03 | $213.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $213.80 | Professional | None | $123.03 | $134.90 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,862.09 Typical High $3,311.31 | Facility | None | $562.34 | $1,862.09 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $323.59 | Professional | None | $125.89 | $199.53 | $323.59 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $295.12 | Professional | None | $123.03 | $190.55 | $295.12 |
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 $61.66 Median $67.61 Typical High $107.15 | Professional | 52 · Reduced service | $61.66 | $67.61 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.92 Typical High $42.66 | Professional | 53 · Discontinued | $24.55 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $102.33 Typical High $158.49 | Professional | 54 · Surgery only | $93.33 | $102.33 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $31.62 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $21.38 |
Where Delaware sits
The same service costs 3.7 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
$214
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.