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 $758.58 Median $6,606.93 Typical High $7,244.36 | Facility | None | $758.58 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $851.14 | Professional | None | $758.58 | $758.58 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $5,888.44 | Facility | None | $1,000.00 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $1,071.52 | Professional | None | $645.65 | $741.31 | $1,071.52 |
Highmark BCBS Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Professional | None | $8,317.64 | $8,317.64 | $8,317.64 |
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 $588.84 Median $691.83 Typical High $1,000.00 | Professional | None | $588.84 | $691.83 | $1,000.00 |
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 $371.54 Median $380.19 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $169.82 | Professional | 53 · Discontinued | $151.36 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $630.96 | Professional | 54 · Surgery only | $562.34 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $125.89 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $85.11 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $588.84 |
Where Delaware sits
The same service costs 6.2 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· 43rd of 51
$741
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.