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 $44.67 Median $229.09 Typical High $7,244.36 | Facility | None | $44.67 | $229.09 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $147.91 Typical High $239.88 | Professional | None | $44.67 | $147.91 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $125.89 Typical High $316.23 | Professional | None | $43.65 | $125.89 | $316.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $457.09 | Facility | None | $70.79 | $70.79 | $457.09 |
Highmark BCBS Setting Professional Modifier None Typical Low $39.81 Median $371.54 Typical High $389.05 | Professional | None | $39.81 | $371.54 | $389.05 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $39.81 Median $165.96 Typical High $331.13 | Professional | None | $39.81 | $165.96 | $331.13 |
4 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 $22.39 Median $31.62 Typical High $117.49 | Professional | 52 · Reduced service | $22.39 | $31.62 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $12.88 Typical High $47.86 | Professional | 53 · Discontinued | $8.91 | $12.88 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $9.55 Typical High $35.48 | Professional | 55 · Aftercare only | $6.61 | $9.55 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.31 Typical High $23.44 | Professional | 56 · Pre-op care only | $4.47 | $6.31 | $23.44 |
Where Delaware sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 41st of 51
$151
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.