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 $154.88 Median $218.78 Typical High $7,244.36 | Facility | None | $154.88 | $218.78 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $234.42 | Professional | None | $154.88 | $199.53 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $831.76 Typical High $1,318.26 | Facility | None | $416.87 | $831.76 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $269.15 | Professional | None | $138.04 | $186.21 | $269.15 |
Highmark BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $128.82 Median $177.83 Typical High $257.04 | Professional | None | $128.82 | $177.83 | $257.04 |
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 $77.62 Median $95.50 Typical High $114.82 | Professional | 52 · Reduced service | $77.62 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.02 Typical High $46.77 | Professional | 53 · Discontinued | $30.90 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $141.25 Typical High $173.78 | Professional | 54 · Surgery only | $117.49 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $28.18 Typical High $34.67 | Professional | 55 · Aftercare only | $23.44 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.05 Typical High $22.91 | Professional | 56 · Pre-op care only | $15.49 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $131.83 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $109.65 | $131.83 | $162.18 |
Where Delaware sits
The same service costs 4.2 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· 44th of 51
$186
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.