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 $114.82 Median $302.00 Typical High $7,244.36 | Facility | None | $114.82 | $302.00 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $269.15 | Professional | None | $114.82 | $208.93 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $426.58 | Professional | None | $138.04 | $223.87 | $426.58 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $4,265.80 | Facility | None | $3,162.28 | $3,162.28 | $4,265.80 |
Highmark BCBS Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $204.17 | Professional | None | $120.23 | $151.36 | $204.17 |
United Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
United Setting Professional Modifier None Typical Low $112.20 Median $229.09 Typical High $398.11 | Professional | None | $112.20 | $229.09 | $398.11 |
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 $57.54 Median $85.11 Typical High $128.82 | Professional | 52 · Reduced service | $57.54 | $85.11 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $33.88 Typical High $51.29 | Professional | 53 · Discontinued | $22.91 | $33.88 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $128.82 Typical High $194.98 | Professional | 54 · Surgery only | $85.11 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $25.70 Typical High $38.90 | Professional | 55 · Aftercare only | $16.98 | $25.70 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.98 Typical High $25.70 | Professional | 56 · Pre-op care only | $11.48 | $16.98 | $25.70 |
Where Delaware sits
The same service costs 3.4 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· 39th of 51
$224
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.