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 $114.82 Median $3,235.94 Typical High $7,244.36 | Facility | None | $114.82 | $3,235.94 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $131.83 | Professional | None | $114.82 | $114.82 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $4,897.79 Typical High $8,709.64 | Facility | None | $416.87 | $4,897.79 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $114.82 Typical High $154.88 | Professional | None | $107.15 | $114.82 | $154.88 |
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 $100.00 Median $112.20 Typical High $162.18 | Professional | None | $100.00 | $112.20 | $162.18 |
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 $57.54 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $57.54 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $26.30 | Professional | 53 · Discontinued | $23.44 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 54 · Surgery only | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $19.95 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $13.18 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $13.18 |
Where Delaware sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 44th of 51
$115
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.