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 $158.49 Median $446.68 Typical High $7,244.36 | Facility | None | $158.49 | $446.68 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $363.08 Typical High $467.74 | Professional | None | $158.49 | $363.08 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,122.02 Typical High $1,737.80 | Facility | None | $416.87 | $1,122.02 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $302.00 Typical High $426.58 | Professional | None | $154.88 | $302.00 | $426.58 |
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 $134.90 Median $302.00 Typical High $446.68 | Professional | None | $134.90 | $302.00 | $446.68 |
5 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 $79.43 Median $120.23 Typical High $234.42 | Professional | 52 · Reduced service | $79.43 | $120.23 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $58.88 Typical High $93.33 | Professional | 53 · Discontinued | $31.62 | $58.88 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $181.97 Typical High $346.74 | Professional | 54 · Surgery only | $117.49 | $181.97 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $36.31 Typical High $69.18 | Professional | 55 · Aftercare only | $23.44 | $36.31 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $23.99 Typical High $46.77 | Professional | 56 · Pre-op care only | $15.85 | $23.99 | $46.77 |
Where Delaware sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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· 43rd of 51
$316
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.