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 $190.55 Median $323.59 Typical High $7,244.36 | Facility | None | $190.55 | $323.59 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $363.08 | Professional | None | $186.21 | $223.87 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $478.63 Typical High $2,137.96 | Facility | None | $323.59 | $478.63 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $316.23 | Professional | None | $109.65 | $181.97 | $316.23 |
Highmark BCBS Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $112.20 Median $181.97 Typical High $309.03 | Professional | None | $112.20 | $181.97 | $309.03 |
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 $93.33 Median $112.20 Typical High $162.18 | Professional | 52 · Reduced service | $93.33 | $112.20 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $44.67 Typical High $66.07 | Professional | 53 · Discontinued | $38.02 | $44.67 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $165.96 Typical High $245.47 | Professional | 54 · Surgery only | $141.25 | $165.96 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.88 Typical High $48.98 | Professional | 55 · Aftercare only | $28.18 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $22.39 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.05 | $22.39 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $154.88 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $131.83 | $154.88 | $229.09 |
Where Delaware sits
The same service costs 4.5 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· 47th of 51
$191
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.