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 $3,548.13 Median $3,548.13 Typical High $7,244.36 | Facility | None | $3,548.13 | $3,548.13 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,073.80 | Professional | None | $3,548.13 | $3,548.13 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $794.33 Typical High $2,290.87 | Facility | None | $676.08 | $794.33 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,467.37 Typical High $4,786.30 | Professional | None | $3,090.30 | $3,467.37 | $4,786.30 |
United Setting Facility Modifier None Typical Low $275.42 Median $446.68 Typical High $4,265.80 | Facility | None | $275.42 | $446.68 | $4,265.80 |
United Setting Professional Modifier None Typical Low $2,951.21 Median $3,388.44 Typical High $4,677.35 | Professional | None | $2,951.21 | $3,388.44 | $4,677.35 |
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 $1,778.28 Median $1,778.28 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $812.83 | Professional | 53 · Discontinued | $707.95 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $602.56 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $407.38 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $2,818.38 |
Where Delaware sits
The same service costs 21.9 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· 41st of 51
$3,467
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.