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 $67.61 Median $177.83 Typical High $7,244.36 | Facility | None | $67.61 | $177.83 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $138.04 Typical High $208.93 | Professional | None | $67.61 | $138.04 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $169.82 Typical High $588.84 | Facility | None | $117.49 | $169.82 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $138.04 Typical High $213.80 | Professional | None | $70.79 | $138.04 | $213.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Facility | None | $6,456.54 | $6,456.54 | $6,456.54 |
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 $66.07 Median $123.03 Typical High $186.21 | Professional | None | $66.07 | $123.03 | $186.21 |
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 $33.88 Median $39.81 Typical High $72.44 | Professional | 52 · Reduced service | $33.88 | $39.81 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.85 Typical High $28.84 | Professional | 53 · Discontinued | $13.49 | $15.85 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $58.88 Typical High $109.65 | Professional | 54 · Surgery only | $50.12 | $58.88 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.75 Typical High $21.88 | Professional | 55 · Aftercare only | $10.23 | $11.75 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.94 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.76 | $7.94 | $14.45 |
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· 34th of 51
$145
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.