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 $125.89 Median $4,073.80 Typical High $7,244.36 | Facility | None | $125.89 | $4,073.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $128.82 | Professional | None | $120.23 | $125.89 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $2,137.96 | Facility | None | $263.03 | $398.11 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $138.04 | Professional | None | $91.20 | $104.71 | $138.04 |
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 $79.43 Median $97.72 Typical High $144.54 | Professional | None | $79.43 | $97.72 | $144.54 |
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 $61.66 Median $63.10 Typical High $64.57 | Professional | 52 · Reduced service | $61.66 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.12 Typical High $25.70 | Professional | 53 · Discontinued | $24.55 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $95.50 Typical High $95.50 | Professional | 54 · Surgery only | $93.33 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $18.62 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.59 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.30 | $12.59 | $12.88 |
Where Delaware sits
The same service costs 4.8 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· 48th of 51
$105
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.