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 $1,174.90 Median $1,174.90 Typical High $7,244.36 | Facility | None | $1,174.90 | $1,174.90 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,174.90 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $794.33 Typical High $2,137.96 | Facility | None | $676.08 | $794.33 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,122.02 | $1,584.89 |
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 $891.25 Median $1,071.52 Typical High $1,479.11 | Professional | None | $891.25 | $1,071.52 | $1,479.11 |
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 $575.44 Median $588.84 Typical High $660.69 | Professional | 52 · Reduced service | $575.44 | $588.84 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $234.42 Typical High $269.15 | Professional | 53 · Discontinued | $229.09 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,000.00 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $117.49 Typical High $131.83 | Professional | 56 · Pre-op care only | $114.82 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $933.25 |
Where Delaware sits
The same service costs 5.5 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· 43rd of 51
$1,122
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.