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 $204.17 Median $891.25 Typical High $7,244.36 | Facility | None | $204.17 | $891.25 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $676.08 Typical High $933.25 | Professional | None | $204.17 | $676.08 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $575.44 Typical High $1,202.26 | Professional | None | $223.87 | $575.44 | $1,202.26 |
United Setting Professional Modifier None Typical Low $186.21 Median $602.56 Typical High $1,288.25 | Professional | None | $186.21 | $602.56 | $1,288.25 |
5 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 $102.33 Median $173.78 Typical High $457.09 | Professional | 52 · Reduced service | $102.33 | $173.78 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $69.18 Typical High $181.97 | Professional | 53 · Discontinued | $41.69 | $69.18 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $263.03 Typical High $660.69 | Professional | 54 · Surgery only | $154.88 | $263.03 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $52.48 Typical High $134.90 | Professional | 55 · Aftercare only | $30.90 | $52.48 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $34.67 Typical High $91.20 | Professional | 56 · Pre-op care only | $20.42 | $34.67 | $91.20 |
Where Delaware sits
The same service costs 5.4 times more in Wisconsin than in Maryland. 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· 45th of 51
$617
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.