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 $407.38 Median $6,606.93 Typical High $7,244.36 | Facility | None | $407.38 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $446.68 | Professional | None | $407.38 | $407.38 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $5,754.40 Typical High $8,912.51 | Facility | None | $1,659.59 | $5,754.40 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $549.54 | Professional | None | $389.05 | $416.87 | $549.54 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $3,388.44 | Facility | None | $1,023.29 | $1,819.70 | $3,388.44 |
United Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $588.84 | Professional | None | $346.74 | $398.11 | $588.84 |
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 $204.17 Median $204.17 Typical High $223.87 | Professional | 52 · Reduced service | $204.17 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $81.28 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | 54 · Surgery only | $302.00 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $67.61 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $44.67 |
Where Delaware sits
The same service costs 4.5 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· 46th of 51
$407
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.