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 $1,071.52 Median $4,073.80 Typical High $7,244.36 | Facility | None | $1,071.52 | $4,073.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,071.52 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,071.52 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,398.83 Typical High $4,265.80 | Facility | None | $616.60 | $2,398.83 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,047.13 | $1,995.26 |
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 $870.96 Median $1,000.00 Typical High $1,513.56 | Professional | None | $870.96 | $1,000.00 | $1,513.56 |
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 $512.86 Median $537.03 Typical High $562.34 | Professional | 52 · Reduced service | $512.86 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $218.78 Typical High $229.09 | Professional | 53 · Discontinued | $208.93 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $851.14 | Professional | 54 · Surgery only | $776.25 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $169.82 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $114.82 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $758.58 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $724.44 | $758.58 | $794.33 |
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
$1,072
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.