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 $169.82 Median $229.09 Typical High $7,244.36 | Facility | None | $169.82 | $229.09 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $234.42 | Professional | None | $169.82 | $181.97 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $1,905.46 Typical High $3,388.44 | Facility | None | $416.87 | $1,905.46 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $338.84 | Professional | None | $162.18 | $229.09 | $338.84 |
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 $165.96 Median $223.87 Typical High $338.84 | Professional | None | $165.96 | $223.87 | $338.84 |
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 $85.11 Median $91.20 Typical High $114.82 | Professional | 52 · Reduced service | $85.11 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $36.31 Typical High $45.71 | Professional | 53 · Discontinued | $33.88 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $134.90 Typical High $173.78 | Professional | 54 · Surgery only | $128.82 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $34.67 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.20 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.98 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $125.89 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $120.23 | $125.89 | $162.18 |
Where Delaware sits
The same service costs 4.4 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· 46th 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.