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 $316.23 Median $4,073.80 Typical High $7,244.36 | Facility | None | $316.23 | $4,073.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $338.84 | Professional | None | $316.23 | $316.23 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,288.25 Typical High $1,862.09 | Facility | None | $562.34 | $1,288.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $616.60 | Professional | None | $302.00 | $346.74 | $616.60 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $537.03 | Professional | None | $295.12 | $338.84 | $537.03 |
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 $158.49 Median $158.49 Typical High $165.96 | Professional | 52 · Reduced service | $158.49 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | 53 · Discontinued | $63.10 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $239.88 Typical High $245.47 | Professional | 54 · Surgery only | $239.88 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $48.98 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $33.11 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $223.87 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $223.87 | $223.87 | $229.09 |
Where Delaware sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 45th of 51
$347
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.