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 $165.96 Median $436.52 Typical High $7,244.36 | Facility | None | $165.96 | $436.52 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $269.15 | Professional | None | $165.96 | $213.80 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $263.03 Typical High $2,137.96 | Facility | None | $169.82 | $263.03 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $288.40 | Professional | None | $144.54 | $204.17 | $288.40 |
Highmark BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Facility | None | $6,456.54 | $6,456.54 | $6,456.54 |
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 $138.04 Median $194.98 Typical High $281.84 | Professional | None | $138.04 | $194.98 | $281.84 |
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 $83.18 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $83.18 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $42.66 Typical High $50.12 | Professional | 53 · Discontinued | $33.11 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $158.49 Typical High $186.21 | Professional | 54 · Surgery only | $123.03 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $31.62 Typical High $37.15 | Professional | 55 · Aftercare only | $24.55 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $21.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.60 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $147.91 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $114.82 | $147.91 | $173.78 |
Where Delaware sits
The same service costs 3.8 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· 41st of 51
$204
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.