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 $549.54 Median $1,445.44 Typical High $7,244.36 | Facility | None | $549.54 | $1,445.44 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $575.44 | Professional | None | $524.81 | $549.54 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,041.74 Typical High $5,754.40 | Facility | None | $954.99 | $2,041.74 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,023.29 | Professional | None | $512.86 | $512.86 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $5,495.41 | Facility | None | $1,023.29 | $1,819.70 | $5,495.41 |
United Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $524.81 | Professional | None | $208.93 | $363.08 | $524.81 |
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 $263.03 Median $275.42 Typical High $281.84 | Professional | 52 · Reduced service | $263.03 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $109.65 Typical High $114.82 | Professional | 53 · Discontinued | $107.15 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $416.87 Typical High $426.58 | Professional | 54 · Surgery only | $398.11 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $85.11 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $54.95 Typical High $57.54 | Professional | 56 · Pre-op care only | $53.70 | $54.95 | $57.54 |
Where Delaware sits
The same service costs 10.5 times more in Alaska than in Hawaii. 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· 41st of 51
$513
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.