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 $407.38 Median $6,025.60 Typical High $7,244.36 | Facility | None | $407.38 | $6,025.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $467.74 | Professional | None | $389.05 | $407.38 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,187.76 Typical High $3,388.44 | Facility | None | $794.33 | $2,187.76 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $549.54 | Professional | None | $354.81 | $398.11 | $549.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $7,244.36 Typical High $8,912.51 | Facility | None | $5,128.61 | $7,244.36 | $8,912.51 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $3,388.44 | Facility | None | $1,023.29 | $1,819.70 | $3,388.44 |
United Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $524.81 | Professional | None | $309.03 | $380.19 | $524.81 |
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 $204.17 Median $204.17 Typical High $234.42 | Professional | 52 · Reduced service | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | 53 · Discontinued | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | 54 · Surgery only | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $331.13 |
Where Delaware sits
The same service costs 5.6 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· 47th of 51
$398
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.