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 $389.05 Median $1,513.56 Typical High $7,244.36 | Facility | None | $389.05 | $1,513.56 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $676.08 Typical High $1,513.56 | Professional | None | $389.05 | $676.08 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,621.81 Typical High $2,344.23 | Facility | None | $645.65 | $1,621.81 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $1,148.15 Typical High $3,090.30 | Professional | None | $467.74 | $1,148.15 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $3,981.07 | Facility | None | $1,412.54 | $2,398.83 | $3,981.07 |
United Setting Professional Modifier None Typical Low $398.11 Median $1,122.02 Typical High $3,801.89 | Professional | None | $398.11 | $1,122.02 | $3,801.89 |
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 $194.98 Median $331.13 Typical High $741.31 | Professional | 52 · Reduced service | $194.98 | $331.13 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $134.90 Typical High $302.00 | Professional | 53 · Discontinued | $77.62 | $134.90 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $501.19 Typical High $1,122.02 | Professional | 54 · Surgery only | $288.40 | $501.19 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $100.00 Typical High $223.87 | Professional | 55 · Aftercare only | $57.54 | $100.00 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $67.61 Typical High $151.36 | Professional | 56 · Pre-op care only | $38.90 | $67.61 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $467.74 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $269.15 | $467.74 | $1,047.13 |
Where Delaware sits
The same service costs 4.9 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· 27th of 51
$1,479
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.