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 $23.99 Median $30.90 Typical High $7,244.36 | Facility | None | $23.99 | $30.90 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $30.20 Typical High $40.74 | Professional | None | $23.44 | $30.20 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $17.78 Median $27.54 Typical High $1,288.25 | Facility | None | $17.78 | $27.54 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $37.15 Typical High $47.86 | Professional | None | $21.88 | $37.15 | $47.86 |
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 $19.50 Median $30.20 Typical High $52.48 | Professional | None | $19.50 | $30.20 | $52.48 |
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 $12.02 Median $12.59 Typical High $15.49 | Professional | 52 · Reduced service | $12.02 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.01 Typical High $6.17 | Professional | 53 · Discontinued | $4.79 | $5.01 | $6.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $18.62 Typical High $23.44 | Professional | 54 · Surgery only | $18.20 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.27 Typical High $4.68 | Professional | 55 · Aftercare only | $3.63 | $4.27 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.82 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.40 | $2.82 | $3.09 |
Where Delaware sits
The same service costs 3.5 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
$30.90
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.