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 $144.54 Median $239.88 Typical High $7,244.36 | Facility | None | $144.54 | $239.88 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $251.19 | Professional | None | $144.54 | $218.78 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $269.15 Typical High $588.84 | Facility | None | $181.97 | $269.15 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $269.15 | Professional | None | $123.03 | $194.98 | $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 $120.23 Median $194.98 Typical High $281.84 | Professional | None | $120.23 | $194.98 | $281.84 |
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 $70.79 Median $109.65 Typical High $125.89 | Professional | 52 · Reduced service | $70.79 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $43.65 Typical High $50.12 | Professional | 53 · Discontinued | $28.84 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $107.15 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $21.38 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $14.45 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $151.36 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $100.00 | $151.36 | $177.83 |
Where Delaware sits
The same service costs 3.5 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· 45th of 51
$195
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.