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 $28.18 Median $102.33 Typical High $7,244.36 | Facility | None | $28.18 | $102.33 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $93.33 Typical High $141.25 | Professional | None | $28.18 | $93.33 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $120.23 Typical High $173.78 | Facility | None | $56.23 | $120.23 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $87.10 Typical High $186.21 | Professional | None | $31.62 | $87.10 | $186.21 |
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 $30.20 Median $70.79 Typical High $151.36 | Professional | None | $30.20 | $70.79 | $151.36 |
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 $14.13 Median $18.20 Typical High $51.29 | Professional | 52 · Reduced service | $14.13 | $18.20 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $7.24 Typical High $20.42 | Professional | 53 · Discontinued | $5.62 | $7.24 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $27.54 Typical High $75.86 | Professional | 54 · Surgery only | $20.89 | $27.54 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.50 Typical High $15.14 | Professional | 55 · Aftercare only | $4.27 | $5.50 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.63 Typical High $10.23 | Professional | 56 · Pre-op care only | $2.82 | $3.63 | $10.23 |
Where Delaware sits
The same service costs 5.4 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· 38th of 51
$93.33
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.