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 $204.17 Median $309.03 Typical High $4,073.80 | Facility | None | $204.17 | $309.03 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $512.86 | Professional | None | $204.17 | $309.03 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,288.25 Typical High $1,949.84 | Facility | None | $562.34 | $1,288.25 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $602.56 | Professional | None | $229.09 | $398.11 | $602.56 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $6,165.95 Typical High $10,471.29 | Facility | None | $1,258.93 | $6,165.95 | $10,471.29 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $676.08 | Professional | None | $223.87 | $346.74 | $676.08 |
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 $102.33 Median $123.03 Typical High $154.88 | Professional | 52 · Reduced service | $102.33 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $40.74 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $186.21 Typical High $229.09 | Professional | 54 · Surgery only | $154.88 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $37.15 Typical High $46.77 | Professional | 55 · Aftercare only | $30.90 | $37.15 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $24.55 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.42 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $173.78 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $144.54 | $173.78 | $213.80 |
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· 33rd of 51
$417
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.