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 $1,288.25 Median $4,897.79 Typical High $7,244.36 | Facility | None | $1,288.25 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,318.26 | Professional | None | $1,230.27 | $1,288.25 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,570.88 Typical High $8,128.31 | Facility | None | $707.95 | $4,570.88 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,202.26 | $2,344.23 |
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 $1,071.52 Median $1,202.26 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,202.26 | $1,819.70 |
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 $616.60 Median $645.65 Typical High $660.69 | Professional | 52 · Reduced service | $616.60 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $257.04 Typical High $263.03 | Professional | 53 · Discontinued | $245.47 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $912.01 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $199.53 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $128.82 Typical High $131.83 | Professional | 56 · Pre-op care only | $123.03 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $933.25 |
Where Delaware sits
The same service costs 11.0 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· 45th of 51
$1,288
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.