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 $56.23 Median $331.13 Typical High $7,244.36 | Facility | None | $56.23 | $331.13 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $162.18 Typical High $331.13 | Professional | None | $44.67 | $162.18 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $173.78 Typical High $457.09 | Professional | None | $47.86 | $173.78 | $457.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $5,495.41 | Facility | None | $1,122.02 | $1,122.02 | $5,495.41 |
Highmark BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $43.65 Median $245.47 Typical High $501.19 | Professional | None | $43.65 | $245.47 | $501.19 |
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 $27.54 Median $38.02 Typical High $162.18 | Professional | 52 · Reduced service | $27.54 | $38.02 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $15.14 Typical High $66.07 | Professional | 53 · Discontinued | $11.22 | $15.14 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $56.23 Typical High $245.47 | Professional | 54 · Surgery only | $41.69 | $56.23 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $11.48 Typical High $48.98 | Professional | 55 · Aftercare only | $8.32 | $11.48 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.59 Typical High $33.11 | Professional | 56 · Pre-op care only | $5.62 | $7.59 | $33.11 |
Where Delaware sits
The same service costs 4.9 times more in Iowa than in Nebraska. 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· 42nd of 51
$200
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.