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 $162.18 Median $263.03 Typical High $7,244.36 | Facility | None | $162.18 | $263.03 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $288.40 | Professional | None | $162.18 | $239.88 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $295.12 Typical High $1,288.25 | Facility | None | $199.53 | $295.12 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $295.12 | Professional | None | $141.25 | $218.78 | $295.12 |
Highmark BCBS Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Highmark BCBS Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $141.25 Median $218.78 Typical High $316.23 | Professional | None | $141.25 | $218.78 | $316.23 |
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 $81.28 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $81.28 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $33.11 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $123.03 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $24.55 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.22 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $169.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $114.82 | $169.82 | $194.98 |
Where Delaware sits
The same service costs 3.6 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· 41st of 51
$219
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.