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 $467.74 Median $3,235.94 Typical High $7,244.36 | Facility | None | $467.74 | $3,235.94 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $524.81 | Professional | None | $457.09 | $467.74 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $1,621.81 Typical High $2,884.03 | Facility | None | $467.74 | $1,621.81 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $645.65 | Professional | None | $398.11 | $416.87 | $645.65 |
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 $323.59 Median $416.87 Typical High $588.84 | Professional | None | $323.59 | $416.87 | $588.84 |
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 $229.09 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $229.09 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $91.20 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $346.74 Typical High $389.05 | Professional | 54 · Surgery only | $338.84 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $69.18 Typical High $77.62 | Professional | 55 · Aftercare only | $67.61 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $46.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $45.71 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $323.59 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $316.23 | $323.59 | $363.08 |
Where Delaware sits
The same service costs 6.2 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· 45th of 51
$417
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.