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 $79.43 Median $208.93 Typical High $7,244.36 | Facility | None | $79.43 | $208.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $257.04 | Professional | None | $79.43 | $120.23 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $131.83 Typical High $588.84 | Facility | None | $83.18 | $131.83 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $177.83 | Professional | None | $85.11 | $117.49 | $177.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $87.10 Median $125.89 Typical High $204.17 | Professional | None | $87.10 | $125.89 | $204.17 |
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 $39.81 Median $46.77 Typical High $60.26 | Professional | 52 · Reduced service | $39.81 | $46.77 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $18.62 Typical High $23.99 | Professional | 53 · Discontinued | $16.22 | $18.62 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $70.79 Typical High $91.20 | Professional | 54 · Surgery only | $60.26 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.13 Typical High $18.20 | Professional | 55 · Aftercare only | $12.02 | $14.13 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.33 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.94 | $9.33 | $12.02 |
Where Delaware sits
The same service costs 3.3 times more in Wisconsin than in Kentucky. 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· 49th of 51
$120
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.