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 $131.83 Typical High $7,244.36 | Facility | None | $114.82 | $131.83 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $173.78 | Professional | None | $114.82 | $131.83 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $147.91 Typical High $588.84 | Facility | None | $95.50 | $147.91 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $213.80 | Professional | None | $120.23 | $147.91 | $213.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $104.71 Median $128.82 Typical High $213.80 | Professional | None | $104.71 | $128.82 | $213.80 |
7 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 $61.66 Typical High $67.61 | Professional | 52 · Reduced service | $57.54 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $24.55 Typical High $26.92 | Professional | 53 · Discontinued | $22.91 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $93.33 Typical High $100.00 | Professional | 54 · Surgery only | $85.11 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.62 Typical High $20.42 | Professional | 55 · Aftercare only | $16.98 | $18.62 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.30 Typical High $13.49 | Professional | 56 · Pre-op care only | $11.48 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $87.10 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $79.43 | $87.10 | $93.33 |
Highmark BCBS Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 50 · Both sides | $213.80 | $213.80 | $213.80 |
Where Delaware sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 48th of 51
$132
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.