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 $416.87 Median $2,570.40 Typical High $16,218.10 | Facility | None | $416.87 | $2,570.40 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $1,096.48 Typical High $2,570.40 | Professional | None | $407.38 | $1,096.48 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $1,071.52 Typical High $3,311.31 | Professional | None | $389.05 | $1,071.52 | $3,311.31 |
United Setting Professional Modifier None Typical Low $331.13 Median $1,862.09 Typical High $3,630.78 | Professional | None | $331.13 | $1,862.09 | $3,630.78 |
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 $204.17 Median $288.40 Typical High $1,288.25 | Professional | 52 · Reduced service | $204.17 | $288.40 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $114.82 Typical High $512.86 | Professional | 53 · Discontinued | $83.18 | $114.82 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $426.58 Typical High $1,949.84 | Professional | 54 · Surgery only | $309.03 | $426.58 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $85.11 Typical High $389.05 | Professional | 55 · Aftercare only | $61.66 | $85.11 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $57.54 Typical High $257.04 | Professional | 56 · Pre-op care only | $40.74 | $57.54 | $257.04 |
Where Delaware sits
The same service costs 6.9 times more in Wisconsin 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· 44th of 51
$1,380
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.