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 $426.58 Median $4,897.79 Typical High $16,218.10 | Facility | None | $426.58 | $4,897.79 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,258.93 Typical High $2,818.38 | Professional | None | $398.11 | $1,258.93 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $1,174.90 Typical High $3,162.28 | Professional | None | $389.05 | $1,174.90 | $3,162.28 |
Highmark BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $11,748.98 | Facility | None | $6,309.57 | $6,309.57 | $11,748.98 |
Highmark BCBS Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $3,162.28 | Professional | None | $489.78 | $616.60 | $3,162.28 |
United Setting Professional Modifier None Typical Low $331.13 Median $1,584.89 Typical High $3,090.30 | Professional | None | $331.13 | $1,584.89 | $3,090.30 |
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 $213.80 Median $281.84 Typical High $1,230.27 | Professional | 52 · Reduced service | $213.80 | $281.84 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $114.82 Typical High $489.78 | Professional | 53 · Discontinued | $85.11 | $114.82 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $426.58 Typical High $1,819.70 | Professional | 54 · Surgery only | $316.23 | $426.58 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $85.11 Typical High $363.08 | Professional | 55 · Aftercare only | $64.57 | $85.11 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $57.54 Typical High $245.47 | Professional | 56 · Pre-op care only | $42.66 | $57.54 | $245.47 |
Where Delaware sits
The same service costs 6.2 times more in Washington 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· 45th of 51
$1,349
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.