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 $43.65 Median $114.82 Typical High $7,244.36 | Facility | None | $43.65 | $114.82 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $91.20 Typical High $120.23 | Professional | None | $43.65 | $91.20 | $120.23 |
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 $38.02 Median $85.11 Typical High $123.03 | Professional | None | $38.02 | $85.11 | $123.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Highmark BCBS Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $81.28 | Professional | None | $69.18 | $75.86 | $81.28 |
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 $37.15 Median $79.43 Typical High $128.82 | Professional | None | $37.15 | $79.43 | $128.82 |
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 $21.88 Median $42.66 Typical High $48.98 | Professional | 52 · Reduced service | $21.88 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $17.38 Typical High $19.50 | Professional | 53 · Discontinued | $8.91 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $64.57 Typical High $72.44 | Professional | 54 · Surgery only | $33.11 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $12.88 Typical High $14.45 | Professional | 55 · Aftercare only | $6.61 | $12.88 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $8.71 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.37 | $8.71 | $9.77 |
Where Delaware sits
The same service costs 2.5 times more in North Carolina than in Florida. 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
$83.18
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.