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 $112.20 Median $173.78 Typical High $7,244.36 | Facility | None | $112.20 | $173.78 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $251.19 | Professional | None | $112.20 | $158.49 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $177.83 Typical High $645.65 | Facility | None | $85.11 | $177.83 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $229.09 | Professional | None | $128.82 | $169.82 | $229.09 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Facility | None | $4,168.69 | $4,168.69 | $4,168.69 |
Highmark BCBS Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $1,000.00 | Professional | None | $181.97 | $181.97 | $1,000.00 |
United Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,698.24 | Facility | None | $229.09 | $398.11 | $1,698.24 |
United Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $229.09 | Professional | None | $97.72 | $144.54 | $229.09 |
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 $56.23 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $56.23 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $25.70 Typical High $34.67 | Professional | 53 · Discontinued | $22.39 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $95.50 Typical High $131.83 | Professional | 54 · Surgery only | $85.11 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.50 Typical High $26.30 | Professional | 55 · Aftercare only | $16.98 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.22 | $12.88 | $17.38 |
Where Delaware sits
The same service costs 3.3 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· 43rd of 51
$158
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.