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 $1,288.25 Median $1,288.25 Typical High $7,244.36 | Facility | None | $1,288.25 | $1,288.25 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,288.25 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $794.33 Typical High $2,137.96 | Facility | None | $676.08 | $794.33 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,258.93 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $3,981.07 | Facility | None | $1,412.54 | $2,398.83 | $3,981.07 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,659.59 | Professional | None | $977.24 | $1,202.26 | $1,659.59 |
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 $645.65 Median $645.65 Typical High $724.44 | Professional | 52 · Reduced service | $645.65 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $295.12 | Professional | 53 · Discontinued | $257.04 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $977.24 Typical High $1,096.48 | Professional | 54 · Surgery only | $954.99 | $977.24 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $194.98 Typical High $218.78 | Professional | 55 · Aftercare only | $190.55 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $912.01 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $891.25 | $912.01 | $1,023.29 |
Where Delaware sits
The same service costs 26.3 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· 43rd of 51
$1,259
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.