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 $39.81 Median $169.82 Typical High $7,244.36 | Facility | None | $39.81 | $169.82 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $117.49 Typical High $177.83 | Professional | None | $39.81 | $117.49 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $151.36 | Facility | None | $56.23 | $66.07 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $89.13 Typical High $162.18 | Professional | None | $35.48 | $89.13 | $162.18 |
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 $33.88 Median $93.33 Typical High $162.18 | Professional | None | $33.88 | $93.33 | $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 $19.95 Median $30.20 Typical High $89.13 | Professional | 52 · Reduced service | $19.95 | $30.20 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $12.02 Typical High $35.48 | Professional | 53 · Discontinued | $7.94 | $12.02 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $45.71 Typical High $134.90 | Professional | 54 · Surgery only | $30.20 | $45.71 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $9.12 Typical High $26.92 | Professional | 55 · Aftercare only | $6.03 | $9.12 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $6.03 Typical High $17.78 | Professional | 56 · Pre-op care only | $3.98 | $6.03 | $17.78 |
Where Delaware sits
The same service costs 4.6 times more in Wisconsin 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· 37th of 51
$105
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.