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 $1,023.29 Median $4,073.80 Typical High $7,244.36 | Facility | None | $1,023.29 | $4,073.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,071.52 | Professional | None | $977.24 | $1,023.29 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $7,244.36 Typical High $12,882.50 | Facility | None | $616.60 | $7,244.36 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $977.24 Typical High $1,862.09 | Professional | None | $954.99 | $977.24 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $3,981.07 | Facility | None | $1,412.54 | $2,398.83 | $3,981.07 |
United Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,445.44 | Professional | None | $812.83 | $954.99 | $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 $512.86 Typical High $537.03 | Professional | 52 · Reduced service | $489.78 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $213.80 | Professional | 53 · Discontinued | $194.98 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $794.33 | Professional | 54 · Surgery only | $724.44 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $158.49 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $107.15 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $741.31 |
Where Delaware sits
The same service costs 6.2 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· 46th of 51
$1,023
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.