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 $245.47 Median $6,025.60 Typical High $7,244.36 | Facility | None | $245.47 | $6,025.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $281.84 | Professional | None | $245.47 | $245.47 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,995.26 Typical High $2,884.03 | Facility | None | $794.33 | $1,995.26 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $354.81 | Professional | None | $218.78 | $234.42 | $354.81 |
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 $190.55 Median $229.09 Typical High $331.13 | Professional | None | $190.55 | $229.09 | $331.13 |
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 $123.03 Median $123.03 Typical High $141.25 | Professional | 52 · Reduced service | $123.03 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $56.23 | Professional | 53 · Discontinued | $48.98 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $181.97 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $28.18 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $169.82 | $169.82 | $194.98 |
Where Delaware sits
The same service costs 6.0 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· 46th of 51
$234
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.