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 $42.66 Median $81.28 Typical High $7,244.36 | Facility | None | $42.66 | $81.28 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $81.28 Typical High $123.03 | Professional | None | $42.66 | $81.28 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $85.11 Typical High $588.84 | Facility | None | $57.54 | $85.11 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $141.25 | Professional | None | $67.61 | $83.18 | $141.25 |
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 $40.74 Median $83.18 Typical High $138.04 | Professional | None | $40.74 | $83.18 | $138.04 |
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 $21.38 Median $36.31 Typical High $40.74 | Professional | 52 · Reduced service | $21.38 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $14.45 Typical High $16.22 | Professional | 53 · Discontinued | $8.71 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $54.95 Typical High $60.26 | Professional | 54 · Surgery only | $32.36 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.96 Typical High $12.02 | Professional | 55 · Aftercare only | $6.46 | $10.96 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $7.24 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.27 | $7.24 | $8.13 |
Where Delaware sits
The same service costs 3.0 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· 41st of 51
$83.18
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.