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 $112.20 Median $190.55 Typical High $7,244.36 | Facility | None | $112.20 | $190.55 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $199.53 | Professional | None | $112.20 | $138.04 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $85.11 Typical High $199.53 | Facility | None | $56.23 | $85.11 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $338.84 | Professional | None | $141.25 | $190.55 | $338.84 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $295.12 | Professional | None | $112.20 | $177.83 | $295.12 |
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 $56.23 Median $69.18 Typical High $95.50 | Professional | 52 · Reduced service | $56.23 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $27.54 Typical High $38.02 | Professional | 53 · Discontinued | $22.39 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $102.33 Typical High $144.54 | Professional | 54 · Surgery only | $83.18 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.89 Typical High $28.84 | Professional | 55 · Aftercare only | $16.98 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.80 Typical High $19.05 | Professional | 56 · Pre-op care only | $11.22 | $13.80 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $95.50 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $77.62 | $95.50 | $134.90 |
Where Delaware sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 44th of 51
$191
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.