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 $109.65 Median $109.65 Typical High $181.97 | Facility | None | $109.65 | $109.65 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $181.97 | Professional | None | $109.65 | $154.88 | $181.97 |
BCBS Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
BCBS Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $707.95 | Professional | None | $281.84 | $457.09 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $302.00 Typical High $426.58 | Facility | None | $186.21 | $302.00 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $380.19 | Professional | None | $154.88 | $223.87 | $380.19 |
United Setting Facility Modifier None Typical Low $223.87 Median $295.12 Typical High $3,090.30 | Facility | None | $223.87 | $295.12 | $3,090.30 |
United Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $457.09 | Professional | None | $158.49 | $229.09 | $457.09 |
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 $54.95 Median $75.86 Typical High $91.20 | Professional | 52 · Reduced service | $54.95 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $30.90 Typical High $36.31 | Professional | 53 · Discontinued | $21.88 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $114.82 Typical High $138.04 | Professional | 54 · Surgery only | $83.18 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.91 Typical High $27.54 | Professional | 55 · Aftercare only | $16.60 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.49 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.96 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $107.15 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $77.62 | $107.15 | $128.82 |
Where Wyoming 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.
Wyoming· 2nd of 51
$380
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.