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 $275.42 Median $4,073.80 Typical High $16,218.10 | Facility | None | $275.42 | $4,073.80 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $724.44 Typical High $1,584.89 | Professional | None | $229.09 | $724.44 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $660.69 Typical High $1,995.26 | Professional | None | $239.88 | $660.69 | $1,995.26 |
Highmark BCBS Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
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 $218.78 Median $616.60 Typical High $2,041.74 | Professional | None | $218.78 | $616.60 | $2,041.74 |
6 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 $138.04 Median $186.21 Typical High $794.33 | Professional | 52 · Reduced service | $138.04 | $186.21 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $74.13 Typical High $316.23 | Professional | 53 · Discontinued | $54.95 | $74.13 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $281.84 Typical High $1,202.26 | Professional | 54 · Surgery only | $208.93 | $281.84 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $56.23 Typical High $239.88 | Professional | 55 · Aftercare only | $41.69 | $56.23 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $37.15 Typical High $158.49 | Professional | 56 · Pre-op care only | $27.54 | $37.15 | $158.49 |
Highmark BCBS Setting Facility Modifier 59 · Distinct service Typical Low $3,311.31 Median $3,311.31 Typical High $4,265.80 | Facility | 59 · Distinct service | $3,311.31 | $3,311.31 | $4,265.80 |
Where Delaware sits
The same service costs 5.8 times more in Washington than in Hawaii. 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
$692
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.