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 $302.00 Median $478.63 Typical High $7,244.36 | Facility | None | $302.00 | $478.63 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $501.19 | Professional | None | $302.00 | $380.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $645.65 Typical High $2,137.96 | Facility | None | $436.52 | $645.65 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $501.19 | Professional | None | $245.47 | $331.13 | $501.19 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $3,981.07 | Facility | None | $1,412.54 | $2,398.83 | $3,981.07 |
United Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $478.63 | Professional | None | $245.47 | $331.13 | $478.63 |
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 $151.36 Median $181.97 Typical High $251.19 | Professional | 52 · Reduced service | $151.36 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $72.44 Typical High $102.33 | Professional | 53 · Discontinued | $60.26 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $275.42 Typical High $380.19 | Professional | 54 · Surgery only | $229.09 | $275.42 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $54.95 Typical High $75.86 | Professional | 55 · Aftercare only | $45.71 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $36.31 Typical High $50.12 | Professional | 56 · Pre-op care only | $30.20 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $257.04 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $213.80 | $257.04 | $354.81 |
Where Delaware sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 49th of 51
$331
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.