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 $676.08 Median $870.96 Typical High $7,244.36 | Facility | None | $676.08 | $870.96 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $912.01 | Professional | None | $676.08 | $831.76 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,311.31 Typical High $5,888.44 | Facility | None | $870.96 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,047.13 | Professional | None | $588.84 | $758.58 | $1,047.13 |
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 $549.54 Median $691.83 Typical High $1,023.29 | Professional | None | $549.54 | $691.83 | $1,023.29 |
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 $331.13 Median $398.11 Typical High $457.09 | Professional | 52 · Reduced service | $331.13 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $158.49 Typical High $181.97 | Professional | 53 · Discontinued | $134.90 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $588.84 Typical High $691.83 | Professional | 54 · Surgery only | $501.19 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $138.04 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $79.43 Typical High $91.20 | Professional | 56 · Pre-op care only | $67.61 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $549.54 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $467.74 | $549.54 | $645.65 |
Where Delaware sits
The same service costs 4.4 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· 43rd of 51
$759
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.