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 $436.52 Median $436.52 Typical High $7,244.36 | Facility | None | $436.52 | $436.52 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $489.78 | Professional | None | $426.58 | $436.52 | $489.78 |
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 $398.11 Median $416.87 Typical High $575.44 | Professional | None | $398.11 | $416.87 | $575.44 |
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 $346.74 Median $407.38 Typical High $575.44 | Professional | None | $346.74 | $407.38 | $575.44 |
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 $213.80 Median $213.80 Typical High $245.47 | Professional | 52 · Reduced service | $213.80 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $87.10 Typical High $97.72 | Professional | 53 · Discontinued | $85.11 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $371.54 | Professional | 54 · Surgery only | $323.59 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $74.13 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $43.65 Typical High $48.98 | Professional | 56 · Pre-op care only | $42.66 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $346.74 |
Where Delaware sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$417
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.