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 $154.88 Median $354.81 Typical High $7,244.36 | Facility | None | $154.88 | $354.81 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $309.03 Typical High $371.54 | Professional | None | $154.88 | $309.03 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $309.03 Typical High $575.44 | Professional | None | $162.18 | $309.03 | $575.44 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
United Setting Professional Modifier None Typical Low $154.88 Median $316.23 Typical High $562.34 | Professional | None | $154.88 | $316.23 | $562.34 |
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 $75.86 Median $112.20 Typical High $177.83 | Professional | 52 · Reduced service | $75.86 | $112.20 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $44.67 Typical High $70.79 | Professional | 53 · Discontinued | $30.90 | $44.67 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $169.82 Typical High $269.15 | Professional | 54 · Surgery only | $114.82 | $169.82 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $33.88 Typical High $53.70 | Professional | 55 · Aftercare only | $22.91 | $33.88 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.39 Typical High $35.48 | Professional | 56 · Pre-op care only | $15.49 | $22.39 | $35.48 |
Where Delaware sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 38th of 51
$309
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.