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 $154.88 Median $204.17 Typical High $7,244.36 | Facility | None | $154.88 | $204.17 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $398.11 | Professional | None | $154.88 | $204.17 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,412.54 Typical High $2,187.76 | Facility | None | $416.87 | $1,412.54 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $331.13 | Professional | None | $151.36 | $208.93 | $331.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $398.11 | Professional | None | $151.36 | $223.87 | $398.11 |
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 $75.86 Median $93.33 Typical High $100.00 | Professional | 52 · Reduced service | $75.86 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.02 Typical High $40.74 | Professional | 53 · Discontinued | $30.90 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $141.25 Typical High $151.36 | Professional | 54 · Surgery only | $114.82 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $28.18 Typical High $30.20 | Professional | 55 · Aftercare only | $22.91 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.05 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.49 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $131.83 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $107.15 | $131.83 | $141.25 |
Where Delaware sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 44th of 51
$234
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.