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 $83.18 Median $213.80 Typical High $7,244.36 | Facility | None | $83.18 | $213.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $165.96 Typical High $229.09 | Professional | None | $83.18 | $165.96 | $229.09 |
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 $72.44 Median $151.36 Typical High $208.93 | Professional | None | $72.44 | $151.36 | $208.93 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $204.17 | Professional | None | $69.18 | $144.54 | $204.17 |
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 $41.69 Median $63.10 Typical High $114.82 | Professional | 52 · Reduced service | $41.69 | $63.10 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $25.12 Typical High $45.71 | Professional | 53 · Discontinued | $16.98 | $25.12 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $95.50 Typical High $169.82 | Professional | 54 · Surgery only | $63.10 | $95.50 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.05 Typical High $33.88 | Professional | 55 · Aftercare only | $12.59 | $19.05 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $12.59 Typical High $22.91 | Professional | 56 · Pre-op care only | $8.32 | $12.59 | $22.91 |
Where Delaware sits
The same service costs 4.5 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· 41st of 51
$151
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.