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 $100.00 Median $223.87 Typical High $7,244.36 | Facility | None | $100.00 | $223.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $239.88 | Professional | None | $100.00 | $181.97 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,584.89 Typical High $2,818.38 | Facility | None | $416.87 | $1,584.89 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $173.78 Typical High $213.80 | Professional | None | $85.11 | $173.78 | $213.80 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None Typical Low $81.28 Median $154.88 Typical High $229.09 | Professional | None | $81.28 | $154.88 | $229.09 |
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 $50.12 Median $72.44 Typical High $117.49 | Professional | 52 · Reduced service | $50.12 | $72.44 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $28.84 Typical High $47.86 | Professional | 53 · Discontinued | $19.95 | $28.84 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $109.65 Typical High $177.83 | Professional | 54 · Surgery only | $75.86 | $109.65 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.88 Typical High $35.48 | Professional | 55 · Aftercare only | $15.14 | $21.88 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.45 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.00 | $14.45 | $23.99 |
Where Delaware sits
The same service costs 4.0 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· 43rd of 51
$155
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.