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 $57.54 Median $75.86 Typical High $7,244.36 | Facility | None | $57.54 | $75.86 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $85.11 | Professional | None | $57.54 | $75.86 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $83.18 Typical High $588.84 | Facility | None | $52.48 | $83.18 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $64.57 Typical High $100.00 | Professional | None | $52.48 | $64.57 | $100.00 |
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 $47.86 Median $66.07 Typical High $100.00 | Professional | None | $47.86 | $66.07 | $100.00 |
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 $28.84 Median $36.31 Typical High $41.69 | Professional | 52 · Reduced service | $28.84 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $14.79 Typical High $16.98 | Professional | 53 · Discontinued | $11.48 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $53.70 Typical High $63.10 | Professional | 54 · Surgery only | $43.65 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.96 Typical High $12.59 | Professional | 55 · Aftercare only | $8.71 | $10.96 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.24 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.75 | $7.24 | $8.32 |
Where Delaware sits
The same service costs 4.3 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· 49th of 51
$66.07
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.