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 $109.65 Median $218.78 Typical High $7,244.36 | Facility | None | $109.65 | $218.78 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $239.88 | Professional | None | $109.65 | $199.53 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $208.93 Typical High $588.84 | Facility | None | $141.25 | $208.93 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $229.09 | Professional | None | $104.71 | $194.98 | $229.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
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 $97.72 Median $173.78 Typical High $251.19 | Professional | None | $97.72 | $173.78 | $251.19 |
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 $54.95 Median $85.11 Typical High $117.49 | Professional | 52 · Reduced service | $54.95 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $34.67 Typical High $46.77 | Professional | 53 · Discontinued | $21.88 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $128.82 Typical High $173.78 | Professional | 54 · Surgery only | $81.28 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $25.70 Typical High $34.67 | Professional | 55 · Aftercare only | $16.22 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.98 Typical High $23.44 | Professional | 56 · Pre-op care only | $10.96 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $120.23 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $75.86 | $120.23 | $162.18 |
Where Delaware sits
The same service costs 3.5 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· 41st of 51
$174
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.