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 $316.23 Median $2,818.38 Typical High $16,218.10 | Facility | None | $316.23 | $2,818.38 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $831.76 Typical High $1,348.96 | Professional | None | $251.19 | $831.76 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $724.44 Typical High $1,778.28 | Professional | None | $263.03 | $724.44 | $1,778.28 |
Highmark BCBS Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $3,311.31 | Facility | None | $331.13 | $331.13 | $3,311.31 |
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 $251.19 Median $707.95 Typical High $1,862.09 | Professional | None | $251.19 | $707.95 | $1,862.09 |
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 $158.49 Median $213.80 Typical High $676.08 | Professional | 52 · Reduced service | $158.49 | $213.80 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $85.11 Typical High $269.15 | Professional | 53 · Discontinued | $63.10 | $85.11 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $323.59 Typical High $1,023.29 | Professional | 54 · Surgery only | $239.88 | $323.59 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $64.57 Typical High $204.17 | Professional | 55 · Aftercare only | $47.86 | $64.57 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $42.66 Typical High $134.90 | Professional | 56 · Pre-op care only | $31.62 | $42.66 | $134.90 |
Where Delaware sits
The same service costs 3.5 times more in Wisconsin than in Maryland. 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· 41st of 51
$759
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.