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 $2,454.71 Median $2,454.71 Typical High $7,244.36 | Facility | None | $2,454.71 | $2,454.71 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,454.71 Typical High $2,818.38 | Professional | None | $2,398.83 | $2,454.71 | $2,818.38 |
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 $2,137.96 Median $2,398.83 Typical High $3,311.31 | Professional | None | $2,137.96 | $2,398.83 | $3,311.31 |
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 $1,905.46 Median $2,290.87 Typical High $3,162.28 | Professional | None | $1,905.46 | $2,290.87 | $3,162.28 |
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 $1,230.27 Median $1,230.27 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $562.34 | Professional | 53 · Discontinued | $489.78 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $416.87 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $281.84 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $1,949.84 |
Where Delaware sits
The same service costs 21.4 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
$2,399
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.