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 $1,258.93 Median $6,025.60 Typical High $7,244.36 | Facility | None | $1,258.93 | $6,025.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,258.93 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $5,623.41 Typical High $10,000.00 | Facility | None | $676.08 | $5,623.41 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,230.27 | $1,698.24 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $5,128.61 Typical High $10,000.00 | Facility | None | $3,019.95 | $5,128.61 | $10,000.00 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,202.26 | $1,621.81 |
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 $630.96 Median $630.96 Typical High $724.44 | Professional | 52 · Reduced service | $630.96 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | 53 · Discontinued | $251.19 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $954.99 Typical High $1,071.52 | Professional | 54 · Surgery only | $933.25 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $190.55 Typical High $213.80 | Professional | 55 · Aftercare only | $186.21 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $144.54 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $891.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $870.96 | $891.25 | $1,000.00 |
Where Delaware sits
The same service costs 25.7 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
$1,230
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.