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 $112.20 Median $218.78 Typical High $7,244.36 | Facility | None | $112.20 | $218.78 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $245.47 | Professional | None | $112.20 | $181.97 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $275.42 Typical High $588.84 | Facility | None | $186.21 | $275.42 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $213.80 | Professional | None | $95.50 | $151.36 | $213.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,388.44 Median $3,981.07 Typical High $6,309.57 | Facility | None | $3,388.44 | $3,981.07 | $6,309.57 |
Highmark BCBS Setting Professional Modifier None Typical Low $239.88 Median $416.87 Typical High $489.78 | Professional | None | $239.88 | $416.87 | $489.78 |
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 $93.33 Median $141.25 Typical High $218.78 | Professional | None | $93.33 | $141.25 | $218.78 |
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 $56.23 Median $75.86 Typical High $117.49 | Professional | 52 · Reduced service | $56.23 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.20 Typical High $46.77 | Professional | 53 · Discontinued | $22.91 | $30.20 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $114.82 Typical High $173.78 | Professional | 54 · Surgery only | $85.11 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.91 Typical High $34.67 | Professional | 55 · Aftercare only | $16.98 | $22.91 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.14 Typical High $23.44 | Professional | 56 · Pre-op care only | $11.22 | $15.14 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $107.15 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $79.43 | $107.15 | $162.18 |
Where Delaware sits
The same service costs 3.5 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· 47th 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.