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 $1,412.54 Median $1,412.54 Typical High $7,244.36 | Facility | None | $1,412.54 | $1,412.54 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,412.54 | $1,412.54 | $1,621.81 |
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 $1,230.27 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,380.38 | $1,905.46 |
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 $1,071.52 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,318.26 | $1,819.70 |
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 $707.95 Median $707.95 Typical High $812.83 | Professional | 52 · Reduced service | $707.95 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $281.84 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,071.52 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,047.13 | $1,071.52 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $239.88 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $162.18 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,000.00 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $977.24 | $1,000.00 | $1,122.02 |
Where Delaware sits
The same service costs 5.2 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
$1,380
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.