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 $1,318.26 Median $1,318.26 Typical High $7,244.36 | Facility | None | $1,318.26 | $1,318.26 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,318.26 | $1,479.11 |
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 $1,148.15 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,258.93 | $1,737.80 |
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 $1,000.00 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,202.26 | $1,698.24 |
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 $645.65 Median $660.69 Typical High $741.31 | Professional | 52 · Reduced service | $645.65 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | 53 · Discontinued | $263.03 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,122.02 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $223.87 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $131.83 Typical High $147.91 | Professional | 56 · Pre-op care only | $128.82 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,047.13 |
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· 44th of 51
$1,259
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.