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 $354.81 Typical High $16,218.10 | Facility | None | $56.23 | $354.81 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $134.90 Typical High $151.36 | Professional | None | $47.86 | $134.90 | $151.36 |
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 $50.12 Median $104.71 Typical High $239.88 | Professional | None | $50.12 | $104.71 | $239.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $47.86 Median $75.86 Typical High $83.18 | Professional | None | $47.86 | $75.86 | $83.18 |
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 $44.67 Median $114.82 Typical High $257.04 | Professional | None | $44.67 | $114.82 | $257.04 |
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 $28.18 Median $38.90 Typical High $72.44 | Professional | 52 · Reduced service | $28.18 | $38.90 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $15.49 Typical High $28.84 | Professional | 53 · Discontinued | $11.22 | $15.49 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $58.88 Typical High $109.65 | Professional | 54 · Surgery only | $41.69 | $58.88 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $11.75 Typical High $21.88 | Professional | 55 · Aftercare only | $8.32 | $11.75 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.76 Typical High $14.45 | Professional | 56 · Pre-op care only | $5.62 | $7.76 | $14.45 |
Where Delaware sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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
$112
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.