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 $125.89 Median $158.49 Typical High $7,244.36 | Facility | None | $125.89 | $158.49 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $158.49 | Professional | None | $125.89 | $154.88 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $154.88 Typical High $588.84 | Facility | None | $100.00 | $154.88 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $263.03 | Professional | None | $144.54 | $173.78 | $263.03 |
United Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,698.24 | Facility | None | $229.09 | $398.11 | $1,698.24 |
United Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $316.23 | Professional | None | $141.25 | $181.97 | $316.23 |
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 $63.10 Median $75.86 Typical High $79.43 | Professional | 52 · Reduced service | $63.10 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.90 Typical High $31.62 | Professional | 53 · Discontinued | $25.12 | $30.90 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $114.82 Typical High $117.49 | Professional | 54 · Surgery only | $95.50 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.91 Typical High $23.99 | Professional | 55 · Aftercare only | $19.05 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $15.85 |
Where Delaware sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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
$178
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.