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 $117.49 Median $309.03 Typical High $7,244.36 | Facility | None | $117.49 | $309.03 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $251.19 | Professional | None | $117.49 | $141.25 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $117.49 Typical High $645.65 | Facility | None | $81.28 | $117.49 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $229.09 | Professional | None | $131.83 | $162.18 | $229.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
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 $138.04 Typical High $218.78 | Professional | None | $104.71 | $138.04 | $218.78 |
6 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 $58.88 Median $67.61 Typical High $74.13 | Professional | 52 · Reduced service | $58.88 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.92 Typical High $30.20 | Professional | 53 · Discontinued | $23.44 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $100.00 Typical High $112.20 | Professional | 54 · Surgery only | $89.13 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.95 Typical High $22.39 | Professional | 55 · Aftercare only | $17.78 | $19.95 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.49 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.75 | $13.49 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $93.33 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $83.18 | $93.33 | $104.71 |
Where Delaware sits
The same service costs 3.9 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· 42nd of 51
$145
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.