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 $331.13 Median $870.96 Typical High $7,244.36 | Facility | None | $331.13 | $870.96 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $501.19 | Professional | None | $331.13 | $416.87 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $3,311.31 Typical High $5,888.44 | Facility | None | $562.34 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $588.84 | Professional | None | $288.40 | $389.05 | $588.84 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $549.54 | Professional | None | $281.84 | $389.05 | $549.54 |
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 $165.96 Median $208.93 Typical High $245.47 | Professional | 52 · Reduced service | $165.96 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $83.18 Typical High $97.72 | Professional | 53 · Discontinued | $66.07 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $309.03 Typical High $371.54 | Professional | 54 · Surgery only | $251.19 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $61.66 Typical High $74.13 | Professional | 55 · Aftercare only | $50.12 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $41.69 Typical High $48.98 | Professional | 56 · Pre-op care only | $33.11 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $288.40 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $234.42 | $288.40 | $346.74 |
Where Delaware sits
The same service costs 4.0 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
$389
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.