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 $346.74 Median $407.38 Typical High $6,606.93 | Facility | None | $346.74 | $407.38 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $741.31 | Professional | None | $331.13 | $371.54 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $2,187.76 Typical High $3,388.44 | Facility | None | $891.25 | $2,187.76 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $660.69 | Professional | None | $398.11 | $446.68 | $660.69 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $6,456.54 Typical High $13,182.57 | Facility | None | $5,754.40 | $6,456.54 | $13,182.57 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None Typical Low $331.13 Median $436.52 Typical High $851.14 | Professional | None | $331.13 | $436.52 | $851.14 |
6 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 $154.88 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $154.88 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $61.66 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $263.03 Typical High $309.03 | Professional | 54 · Surgery only | $234.42 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $52.48 Typical High $61.66 | Professional | 55 · Aftercare only | $46.77 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $35.48 Typical High $40.74 | Professional | 56 · Pre-op care only | $30.90 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $245.47 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $218.78 | $245.47 | $288.40 |
Where Delaware sits
The same service costs 3.8 times more in Alaska than in Utah. 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· 40th of 51
$457
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.