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 $194.98 Median $295.12 Typical High $7,244.36 | Facility | None | $194.98 | $295.12 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $338.84 | Professional | None | $194.98 | $263.03 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $389.05 Typical High $588.84 | Facility | None | $263.03 | $389.05 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $323.59 | Professional | None | $162.18 | $213.80 | $323.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,677.35 | Facility | None | $3,801.89 | $3,801.89 | $4,677.35 |
Highmark BCBS Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $575.44 | Professional | None | $295.12 | $478.63 | $575.44 |
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 $158.49 Median $208.93 Typical High $302.00 | Professional | None | $158.49 | $208.93 | $302.00 |
6 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 $97.72 Median $114.82 Typical High $154.88 | Professional | 52 · Reduced service | $97.72 | $114.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $45.71 Typical High $61.66 | Professional | 53 · Discontinued | $38.90 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $173.78 Typical High $234.42 | Professional | 54 · Surgery only | $147.91 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $34.67 Typical High $46.77 | Professional | 55 · Aftercare only | $29.51 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.91 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.50 | $22.91 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $162.18 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $138.04 | $162.18 | $218.78 |
Where Delaware sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 50th of 51
$214
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.