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 $1,380.38 Median $4,897.79 Typical High $7,244.36 | Facility | None | $1,380.38 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,318.26 | $1,380.38 | $1,445.44 |
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 $1,288.25 Median $1,318.26 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,318.26 | $2,511.89 |
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 $1,174.90 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,288.25 | $1,995.26 |
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 $660.69 Median $691.83 Typical High $724.44 | Professional | 52 · Reduced service | $660.69 | $691.83 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $288.40 | Professional | 53 · Discontinued | $269.15 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $218.78 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $144.54 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $1,023.29 |
Where Delaware sits
The same service costs 24.5 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
$1,380
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.