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 $1,047.13 Median $1,047.13 Typical High $7,244.36 | Facility | None | $1,047.13 | $1,047.13 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,096.48 | Professional | None | $1,000.00 | $1,047.13 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $794.33 Typical High $2,137.96 | Facility | None | $676.08 | $794.33 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,659.59 | Professional | None | $812.83 | $812.83 | $1,659.59 |
United Setting Facility Modifier None Typical Low $275.42 Median $446.68 Typical High $4,265.80 | Facility | None | $275.42 | $446.68 | $4,265.80 |
United Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,445.44 | Professional | None | $660.69 | $912.01 | $1,445.44 |
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 $489.78 Median $524.81 Typical High $549.54 | Professional | 52 · Reduced service | $489.78 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $208.93 Typical High $223.87 | Professional | 53 · Discontinued | $199.53 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $741.31 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $158.49 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $100.00 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $691.83 | $741.31 | $776.25 |
Where Delaware sits
The same service costs 21.9 times more in Alaska than in Texas. 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· 46th of 51
$912
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.