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 $3,235.94 Typical High $7,244.36 | Facility | None | $125.89 | $3,235.94 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $128.82 | Professional | None | $125.89 | $125.89 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $245.47 | Professional | None | $109.65 | $138.04 | $245.47 |
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 $112.20 Median $138.04 Typical High $302.00 | Professional | None | $112.20 | $138.04 | $302.00 |
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 $63.10 Median $63.10 Typical High $64.57 | Professional | 52 · Reduced service | $63.10 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $26.30 | Professional | 53 · Discontinued | $25.12 | $25.12 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | 54 · Surgery only | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $12.88 |
Where Delaware sits
The same service costs 3.7 times more in Alaska than in New York. 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· 46th of 51
$135
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.