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 $269.15 Median $288.40 Typical High $7,244.36 | Facility | None | $269.15 | $288.40 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $380.19 | Professional | None | $288.40 | $288.40 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,311.31 Typical High $5,888.44 | Facility | None | $645.65 | $3,311.31 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $426.58 | Professional | None | $257.04 | $275.42 | $426.58 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $7,079.46 Typical High $30,902.95 | Facility | None | $3,801.89 | $7,079.46 | $30,902.95 |
Highmark BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $489.78 | Professional | None | $302.00 | $302.00 | $489.78 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $389.05 | Professional | None | $229.09 | $269.15 | $389.05 |
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 $144.54 Median $144.54 Typical High $165.96 | Professional | 52 · Reduced service | $144.54 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $66.07 | Professional | 53 · Discontinued | $57.54 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $245.47 | Professional | 54 · Surgery only | $218.78 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $33.11 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $204.17 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $204.17 | $204.17 | $229.09 |
Where Delaware sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$288
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.