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 $23.99 Median $23.99 Typical High $54.95 | Facility | None | $23.99 | $23.99 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $50.12 Typical High $61.66 | Professional | None | $23.99 | $50.12 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $58.88 Typical High $151.36 | Facility | None | $39.81 | $58.88 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $52.48 Typical High $79.43 | Professional | None | $28.18 | $52.48 | $79.43 |
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 $26.92 Median $46.77 Typical High $74.13 | Professional | None | $26.92 | $46.77 | $74.13 |
4 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 $11.75 Median $15.14 Typical High $27.54 | Professional | 52 · Reduced service | $11.75 | $15.14 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $6.03 Typical High $10.96 | Professional | 53 · Discontinued | $4.79 | $6.03 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $4.57 Typical High $8.32 | Professional | 55 · Aftercare only | $3.55 | $4.57 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $3.02 Typical High $5.50 | Professional | 56 · Pre-op care only | $2.40 | $3.02 | $5.50 |
Where Delaware sits
The same service costs 3.5 times more in Wisconsin 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· 34th of 51
$54.95
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.