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 $79.43 Median $117.49 Typical High $7,244.36 | Facility | None | $79.43 | $117.49 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $177.83 | Professional | None | $79.43 | $112.20 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $707.95 Typical High $2,290.87 | Facility | None | $125.89 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $162.18 | Professional | None | $91.20 | $117.49 | $162.18 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $275.42 | Professional | None | $123.03 | $123.03 | $275.42 |
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 $69.18 Median $97.72 Typical High $158.49 | Professional | None | $69.18 | $97.72 | $158.49 |
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 $39.81 Median $44.67 Typical High $58.88 | Professional | 52 · Reduced service | $39.81 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $17.78 Typical High $23.44 | Professional | 53 · Discontinued | $15.85 | $17.78 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $67.61 Typical High $89.13 | Professional | 54 · Surgery only | $58.88 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.49 Typical High $17.78 | Professional | 55 · Aftercare only | $11.75 | $13.49 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.91 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.94 | $8.91 | $11.75 |
Where Delaware sits
The same service costs 3.5 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
$107
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.