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 $60.26 Median $162.18 Typical High $7,244.36 | Facility | None | $60.26 | $162.18 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $169.82 | Professional | None | $60.26 | $117.49 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $239.88 | Professional | None | $60.26 | $117.49 | $239.88 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $54.95 Median $125.89 Typical High $323.59 | Professional | None | $54.95 | $125.89 | $323.59 |
5 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 $30.20 Median $52.48 Typical High $83.18 | Professional | 52 · Reduced service | $30.20 | $52.48 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $20.89 Typical High $33.11 | Professional | 53 · Discontinued | $12.02 | $20.89 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $77.62 Typical High $125.89 | Professional | 54 · Surgery only | $45.71 | $77.62 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $15.49 Typical High $25.12 | Professional | 55 · Aftercare only | $9.12 | $15.49 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $10.47 Typical High $16.60 | Professional | 56 · Pre-op care only | $6.03 | $10.47 | $16.60 |
Where Delaware sits
The same service costs 3.7 times more in Wisconsin than in Maryland. 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· 42nd of 51
$123
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.