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 $630.96 Median $4,897.79 Typical High $7,244.36 | Facility | None | $630.96 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $630.96 Typical High $707.95 | Professional | None | $616.60 | $630.96 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $2,818.38 | Facility | None | $707.95 | $1,905.46 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $831.76 | Professional | None | $501.19 | $602.56 | $831.76 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $776.25 | Professional | None | $457.09 | $562.34 | $776.25 |
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 $309.03 Median $316.23 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $125.89 Typical High $141.25 | Professional | 53 · Discontinued | $123.03 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $467.74 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $63.10 Typical High $70.79 | Professional | 56 · Pre-op care only | $61.66 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $436.52 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $436.52 | $501.19 |
Where Delaware sits
The same service costs 5.6 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· 42nd of 51
$603
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.