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 $83.18 Median $218.78 Typical High $7,244.36 | Facility | None | $83.18 | $218.78 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $199.53 Typical High $245.47 | Professional | None | $77.62 | $199.53 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $134.90 Typical High $295.12 | Professional | None | $67.61 | $134.90 | $295.12 |
Highmark BCBS Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $1,096.48 | Facility | None | $288.40 | $288.40 | $1,096.48 |
Highmark BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $66.07 Median $158.49 Typical High $309.03 | Professional | None | $66.07 | $158.49 | $309.03 |
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 $39.81 Median $56.23 Typical High $117.49 | Professional | 52 · Reduced service | $39.81 | $56.23 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $22.39 Typical High $46.77 | Professional | 53 · Discontinued | $15.85 | $22.39 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $83.18 Typical High $177.83 | Professional | 54 · Surgery only | $60.26 | $83.18 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.60 Typical High $35.48 | Professional | 55 · Aftercare only | $12.02 | $16.60 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.22 Typical High $23.44 | Professional | 56 · Pre-op care only | $7.94 | $11.22 | $23.44 |
Where Delaware sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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
$158
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.