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 $109.65 Median $162.18 Typical High $7,244.36 | Facility | None | $109.65 | $162.18 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $288.40 | Professional | None | $109.65 | $162.18 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $165.96 Typical High $588.84 | Facility | None | $104.71 | $165.96 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $239.88 | Professional | None | $117.49 | $162.18 | $239.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Facility | None | $7,079.46 | $7,079.46 | $7,079.46 |
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 $120.23 Median $169.82 Typical High $275.42 | Professional | None | $120.23 | $169.82 | $275.42 |
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 $54.95 Median $63.10 Typical High $81.28 | Professional | 52 · Reduced service | $54.95 | $63.10 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $25.70 Typical High $32.36 | Professional | 53 · Discontinued | $21.88 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $95.50 Typical High $123.03 | Professional | 54 · Surgery only | $81.28 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.05 Typical High $24.55 | Professional | 55 · Aftercare only | $16.22 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.88 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.96 | $12.88 | $16.22 |
Where Delaware sits
The same service costs 3.7 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· 45th of 51
$170
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.