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 $269.15 Median $691.83 Typical High $7,244.36 | Facility | None | $269.15 | $691.83 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $416.87 | Professional | None | $269.15 | $354.81 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,862.09 Typical High $2,884.03 | Facility | None | $562.34 | $1,862.09 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $467.74 | Professional | None | $234.42 | $316.23 | $467.74 |
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 $229.09 Median $302.00 Typical High $436.52 | Professional | None | $229.09 | $302.00 | $436.52 |
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 $131.83 Median $165.96 Typical High $194.98 | Professional | 52 · Reduced service | $131.83 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $66.07 Typical High $77.62 | Professional | 53 · Discontinued | $53.70 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $245.47 Typical High $295.12 | Professional | 54 · Surgery only | $199.53 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $39.81 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $33.11 Typical High $38.90 | Professional | 56 · Pre-op care only | $26.92 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $229.09 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $186.21 | $229.09 | $275.42 |
Where Delaware sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 43rd of 51
$316
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.