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 $416.87 Median $3,235.94 Typical High $7,244.36 | Facility | None | $416.87 | $3,235.94 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | None | $416.87 | $416.87 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $173.78 Typical High $257.04 | Facility | None | $58.88 | $173.78 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $575.44 | Professional | None | $363.08 | $363.08 | $575.44 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $537.03 | Professional | None | $323.59 | $380.19 | $537.03 |
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 $204.17 Median $204.17 Typical High $234.42 | Professional | 52 · Reduced service | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $83.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | 54 · Surgery only | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $46.77 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $331.13 |
Where Delaware sits
The same service costs 4.2 times more in Wyoming 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· 47th of 51
$363
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.