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 $30.90 Median $79.43 Typical High $7,244.36 | Facility | None | $30.90 | $79.43 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $79.43 Typical High $104.71 | Professional | None | $30.90 | $79.43 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $75.86 Typical High $112.20 | Facility | None | $56.23 | $75.86 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $69.18 Typical High $125.89 | Professional | None | $38.90 | $69.18 | $125.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $32.36 Median $338.84 Typical High $1,348.96 | Facility | None | $32.36 | $338.84 | $1,348.96 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $31.62 Median $72.44 Typical High $125.89 | Professional | None | $31.62 | $72.44 | $125.89 |
5 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 $15.49 Median $23.99 Typical High $39.81 | Professional | 52 · Reduced service | $15.49 | $23.99 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $9.55 Typical High $16.22 | Professional | 53 · Discontinued | $6.31 | $9.55 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $35.48 Typical High $60.26 | Professional | 54 · Surgery only | $23.44 | $35.48 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $7.24 Typical High $12.02 | Professional | 55 · Aftercare only | $4.68 | $7.24 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.79 Typical High $7.94 | Professional | 56 · Pre-op care only | $3.09 | $4.79 | $7.94 |
Where Delaware sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 33rd of 51
$79.43
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.