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 $257.04 Median $660.69 Typical High $7,244.36 | Facility | None | $257.04 | $660.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $467.74 | Professional | None | $257.04 | $346.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,511.89 Typical High $4,466.84 | Facility | None | $562.34 | $2,511.89 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $645.65 | Professional | None | $281.84 | $407.38 | $645.65 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,918.31 | Facility | None | $5,754.40 | $5,754.40 | $6,918.31 |
Highmark BCBS Setting Professional Modifier None Typical Low $295.12 Median $794.33 Typical High $794.33 | Professional | None | $295.12 | $794.33 | $794.33 |
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 $239.88 Median $380.19 Typical High $660.69 | Professional | None | $239.88 | $380.19 | $660.69 |
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 $125.89 Median $158.49 Typical High $181.97 | Professional | 52 · Reduced service | $125.89 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $63.10 Typical High $72.44 | Professional | 53 · Discontinued | $51.29 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $234.42 Typical High $269.15 | Professional | 54 · Surgery only | $190.55 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $46.77 Typical High $54.95 | Professional | 55 · Aftercare only | $38.02 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $31.62 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.70 | $31.62 | $36.31 |
Where Delaware sits
The same service costs 3.9 times more in Alaska than in New York. 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· 43rd of 51
$398
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.