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 $346.74 Median $3,235.94 Typical High $7,244.36 | Facility | None | $346.74 | $3,235.94 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $346.74 Typical High $363.08 | Professional | None | $338.84 | $346.74 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $549.54 Typical High $2,290.87 | Facility | None | $416.87 | $549.54 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $645.65 | Professional | None | $323.59 | $363.08 | $645.65 |
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 $295.12 Median $338.84 Typical High $512.86 | Professional | None | $295.12 | $338.84 | $512.86 |
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 $169.82 Median $173.78 Typical High $181.97 | Professional | 52 · Reduced service | $169.82 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 53 · Discontinued | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $263.03 Typical High $275.42 | Professional | 54 · Surgery only | $257.04 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $52.48 Typical High $54.95 | Professional | 55 · Aftercare only | $51.29 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $34.67 Typical High $36.31 | Professional | 56 · Pre-op care only | $33.88 | $34.67 | $36.31 |
Where Delaware sits
The same service costs 4.9 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· 44th of 51
$363
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.