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 $190.55 Median $234.42 Typical High $7,244.36 | Facility | None | $190.55 | $234.42 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | None | $190.55 | $213.80 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $288.40 Typical High $588.84 | Facility | None | $181.97 | $288.40 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $389.05 | Professional | None | $208.93 | $263.03 | $389.05 |
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 $199.53 Median $281.84 Typical High $426.58 | Professional | None | $199.53 | $281.84 | $426.58 |
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 $95.50 Median $107.15 Typical High $117.49 | Professional | 52 · Reduced service | $95.50 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $42.66 Typical High $46.77 | Professional | 53 · Discontinued | $38.02 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $158.49 Typical High $177.83 | Professional | 54 · Surgery only | $141.25 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $31.62 Typical High $35.48 | Professional | 55 · Aftercare only | $28.84 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.38 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.05 | $21.38 | $23.44 |
Where Delaware sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 47th of 51
$251
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.