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 $46.77 Median $131.83 Typical High $7,244.36 | Facility | None | $46.77 | $131.83 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $104.71 Typical High $147.91 | Professional | None | $46.77 | $104.71 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $190.55 Typical High $588.84 | Facility | None | $125.89 | $190.55 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $93.33 Typical High $131.83 | Professional | None | $43.65 | $93.33 | $131.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
Highmark BCBS Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
United Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,698.24 | Facility | None | $229.09 | $398.11 | $1,698.24 |
United Setting Professional Modifier None Typical Low $40.74 Median $89.13 Typical High $128.82 | Professional | None | $40.74 | $89.13 | $128.82 |
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 $23.44 Median $40.74 Typical High $70.79 | Professional | 52 · Reduced service | $23.44 | $40.74 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $16.98 Typical High $28.18 | Professional | 53 · Discontinued | $9.33 | $16.98 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $60.26 Typical High $104.71 | Professional | 54 · Surgery only | $35.48 | $60.26 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $12.02 Typical High $20.89 | Professional | 55 · Aftercare only | $7.08 | $12.02 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $8.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $4.68 | $8.13 | $14.13 |
Where Delaware sits
The same service costs 3.5 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· 40th of 51
$95.50
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.