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 $1,174.90 Median $1,513.56 Typical High $7,244.36 | Facility | None | $1,174.90 | $1,513.56 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $1,513.56 | Professional | None | $1,148.15 | $1,230.27 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $5,888.44 | Facility | None | $1,000.00 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,380.38 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $3,981.07 | Facility | None | $1,412.54 | $2,398.83 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,479.11 | $2,454.71 |
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 $575.44 Median $616.60 Typical High $758.58 | Professional | 52 · Reduced service | $575.44 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $251.19 Typical High $302.00 | Professional | 53 · Discontinued | $229.09 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $870.96 | $933.25 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $229.09 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $123.03 Typical High $151.36 | Professional | 56 · Pre-op care only | $114.82 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $1,071.52 |
Where Delaware sits
The same service costs 5.2 times more in Alaska 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· 42nd of 51
$1,514
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.