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 $616.60 Median $6,025.60 Typical High $7,244.36 | Facility | None | $616.60 | $6,025.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | None | $616.60 | $616.60 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $3,467.37 | Facility | None | $1,659.59 | $2,344.23 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $812.83 | Professional | None | $524.81 | $588.84 | $812.83 |
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 $467.74 Median $562.34 Typical High $776.25 | Professional | None | $467.74 | $562.34 | $776.25 |
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 $302.00 Median $302.00 Typical High $346.74 | Professional | 52 · Reduced service | $302.00 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $123.03 Typical High $138.04 | Professional | 53 · Discontinued | $120.23 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $524.81 | Professional | 54 · Surgery only | $457.09 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $104.71 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $61.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $60.26 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $489.78 |
Where Delaware sits
The same service costs 5.9 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
$589
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.