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 $575.44 Median $575.44 Typical High $7,244.36 | Facility | None | $575.44 | $575.44 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $645.65 | Professional | None | $562.34 | $575.44 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $891.25 Typical High $1,318.26 | Facility | None | $467.74 | $891.25 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $758.58 | Professional | None | $512.86 | $549.54 | $758.58 |
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 $436.52 Median $524.81 Typical High $741.31 | Professional | None | $436.52 | $524.81 | $741.31 |
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 $281.84 Median $281.84 Typical High $323.59 | Professional | 52 · Reduced service | $281.84 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $114.82 Typical High $128.82 | Professional | 53 · Discontinued | $112.20 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | 54 · Surgery only | $426.58 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $97.72 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $56.23 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $457.09 |
Where Delaware sits
The same service costs 5.5 times more in Alaska than in Texas. 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
$550
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.