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 $100.00 Median $128.82 Typical High $7,244.36 | Facility | None | $100.00 | $128.82 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $154.88 | Professional | None | $100.00 | $128.82 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $85.11 Typical High $169.82 | Facility | None | $56.23 | $85.11 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $213.80 | Professional | None | $97.72 | $134.90 | $213.80 |
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 $100.00 Median $144.54 Typical High $251.19 | Professional | None | $100.00 | $144.54 | $251.19 |
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 $48.98 Median $60.26 Typical High $64.57 | Professional | 52 · Reduced service | $48.98 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $24.55 Typical High $25.70 | Professional | 53 · Discontinued | $19.95 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $91.20 Typical High $97.72 | Professional | 54 · Surgery only | $74.13 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $18.20 Typical High $19.50 | Professional | 55 · Aftercare only | $14.79 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.02 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.00 | $12.02 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $85.11 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $69.18 | $85.11 | $91.20 |
Where Delaware sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 48th of 51
$129
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.