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 $707.95 Median $7,244.36 Typical High $7,585.78 | Facility | None | $707.95 | $7,244.36 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $707.95 Typical High $794.33 | Professional | None | $691.83 | $707.95 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $3,801.89 Typical High $5,888.44 | Facility | None | $1,258.93 | $3,801.89 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $1,000.00 | Professional | None | $616.60 | $676.08 | $1,000.00 |
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 $575.44 Median $691.83 Typical High $977.24 | Professional | None | $575.44 | $691.83 | $977.24 |
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 $346.74 Median $354.81 Typical High $398.11 | Professional | 52 · Reduced service | $346.74 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $141.25 Typical High $158.49 | Professional | 53 · Discontinued | $138.04 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $524.81 Typical High $602.56 | Professional | 54 · Surgery only | $512.86 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $104.71 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $70.79 Typical High $79.43 | Professional | 56 · Pre-op care only | $69.18 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $489.78 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $478.63 | $489.78 | $562.34 |
Where Delaware sits
The same service costs 6.3 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· 44th of 51
$692
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.