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 $223.87 Median $354.81 Typical High $7,244.36 | Facility | None | $223.87 | $354.81 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $380.19 | Professional | None | $223.87 | $288.40 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $416.87 Typical High $2,137.96 | Facility | None | $281.84 | $416.87 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $389.05 | Professional | None | $194.98 | $281.84 | $389.05 |
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 $186.21 Median $269.15 Typical High $389.05 | Professional | None | $186.21 | $269.15 | $389.05 |
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 $109.65 Median $138.04 Typical High $190.55 | Professional | 52 · Reduced service | $109.65 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $54.95 Typical High $75.86 | Professional | 53 · Discontinued | $44.67 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $208.93 Typical High $281.84 | Professional | 54 · Surgery only | $165.96 | $208.93 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $41.69 Typical High $56.23 | Professional | 55 · Aftercare only | $33.11 | $41.69 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $27.54 Typical High $38.02 | Professional | 56 · Pre-op care only | $22.39 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $194.98 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $154.88 | $194.98 | $263.03 |
Where Delaware sits
The same service costs 3.6 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· 44th of 51
$282
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.