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 $4,265.80 Median $4,265.80 Typical High $7,244.36 | Facility | None | $4,265.80 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $4,168.69 Median $4,265.80 Typical High $4,786.30 | Professional | None | $4,168.69 | $4,265.80 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $794.33 Typical High $2,290.87 | Facility | None | $676.08 | $794.33 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $4,073.80 Typical High $5,623.41 | Professional | None | $3,467.37 | $4,073.80 | $5,623.41 |
United Setting Facility Modifier None Typical Low $275.42 Median $446.68 Typical High $4,265.80 | Facility | None | $275.42 | $446.68 | $4,265.80 |
United Setting Professional Modifier None Typical Low $3,090.30 Median $3,801.89 Typical High $5,248.07 | Professional | None | $3,090.30 | $3,801.89 | $5,248.07 |
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 $2,089.30 Median $2,089.30 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,089.30 | $2,089.30 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $851.14 Typical High $954.99 | Professional | 53 · Discontinued | $831.76 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,162.28 Typical High $3,630.78 | Professional | 54 · Surgery only | $3,162.28 | $3,162.28 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | 55 · Aftercare only | $630.96 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $426.58 Typical High $478.63 | Professional | 56 · Pre-op care only | $416.87 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $2,951.21 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $2,951.21 | $2,951.21 | $3,388.44 |
Where Delaware sits
The same service costs 21.9 times more in Alaska than in Texas. 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· 40th of 51
$4,074
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.