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 $60.26 Median $3,235.94 Typical High $7,244.36 | Facility | None | $60.26 | $3,235.94 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $60.26 Typical High $61.66 | Professional | None | $58.88 | $60.26 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $588.84 | Facility | None | $263.03 | $398.11 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $50.12 Typical High $67.61 | Professional | None | $47.86 | $50.12 | $67.61 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $42.66 Median $47.86 Typical High $70.79 | Professional | None | $42.66 | $47.86 | $70.79 |
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 $29.51 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $29.51 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.02 Typical High $12.30 | Professional | 53 · Discontinued | $11.75 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $45.71 Typical High $45.71 | Professional | 54 · Surgery only | $44.67 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $8.91 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.89 | $6.03 | $6.03 |
Where Delaware sits
The same service costs 4.2 times more in Alaska 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· 49th of 51
$50.12
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.