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 $208.93 Median $316.23 Typical High $7,244.36 | Facility | None | $208.93 | $316.23 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $467.74 | Professional | None | $208.93 | $316.23 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $457.09 Typical High $588.84 | Facility | None | $323.59 | $457.09 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $524.81 | Professional | None | $208.93 | $295.12 | $524.81 |
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 $208.93 Median $309.03 Typical High $537.03 | Professional | None | $208.93 | $309.03 | $537.03 |
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 $104.71 Median $114.82 Typical High $158.49 | Professional | 52 · Reduced service | $104.71 | $114.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $46.77 Typical High $63.10 | Professional | 53 · Discontinued | $41.69 | $46.77 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $173.78 Typical High $239.88 | Professional | 54 · Surgery only | $154.88 | $173.78 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $34.67 Typical High $47.86 | Professional | 55 · Aftercare only | $31.62 | $34.67 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.44 Typical High $31.62 | Professional | 56 · Pre-op care only | $20.89 | $23.44 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $162.18 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $144.54 | $162.18 | $223.87 |
Where Delaware sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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· 41st of 51
$309
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.