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 $1,348.96 Median $1,348.96 Typical High $7,244.36 | Facility | None | $1,348.96 | $1,348.96 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,348.96 | $1,348.96 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $794.33 Typical High $2,238.72 | Facility | None | $676.08 | $794.33 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,318.26 | $1,819.70 |
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 $1,023.29 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,258.93 | $1,737.80 |
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 $676.08 Median $676.08 Typical High $776.25 | Professional | 52 · Reduced service | $676.08 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $309.03 | Professional | 53 · Discontinued | $269.15 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $154.88 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $1,071.52 |
Where Delaware sits
The same service costs 5.4 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
$1,318
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.