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 $67.61 Median $177.83 Typical High $7,244.36 | Facility | None | $67.61 | $177.83 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $147.91 | Professional | None | $67.61 | $117.49 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $104.71 Typical High $151.36 | Facility | None | $58.88 | $104.71 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $165.96 | Professional | None | $64.57 | $109.65 | $165.96 |
Highmark BCBS Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | None | $117.49 | $125.89 | $125.89 |
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 $58.88 Median $97.72 Typical High $154.88 | Professional | None | $58.88 | $97.72 | $154.88 |
6 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 $33.88 Median $42.66 Typical High $69.18 | Professional | 52 · Reduced service | $33.88 | $42.66 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $16.98 Typical High $27.54 | Professional | 53 · Discontinued | $13.49 | $16.98 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $63.10 Typical High $102.33 | Professional | 54 · Surgery only | $51.29 | $63.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $10.23 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $11.75 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.76 | $11.75 | $13.80 |
Highmark BCBS Setting Facility Modifier 59 · Distinct service Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | 59 · Distinct service | $93.33 | $93.33 | $93.33 |
Where Delaware sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 45th of 51
$110
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.