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 $128.82 Median $234.42 Typical High $7,244.36 | Facility | None | $128.82 | $234.42 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $251.19 | Professional | None | $128.82 | $194.98 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $275.42 Typical High $588.84 | Facility | None | $186.21 | $275.42 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $239.88 | Professional | None | $114.82 | $190.55 | $239.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $204.17 Median $7,079.46 Typical High $7,079.46 | Facility | None | $204.17 | $7,079.46 | $7,079.46 |
Highmark BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $213.80 | Professional | None | $134.90 | $134.90 | $213.80 |
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 $109.65 Median $173.78 Typical High $251.19 | Professional | None | $109.65 | $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 $64.57 Median $95.50 Typical High $123.03 | Professional | 52 · Reduced service | $64.57 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $38.02 Typical High $50.12 | Professional | 53 · Discontinued | $26.30 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $144.54 Typical High $186.21 | Professional | 54 · Surgery only | $97.72 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.84 Typical High $37.15 | Professional | 55 · Aftercare only | $19.50 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.88 | $19.05 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $134.90 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $91.20 | $134.90 | $173.78 |
Where Delaware sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 40th of 51
$186
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.