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 $912.01 Median $4,897.79 Typical High $7,244.36 | Facility | None | $912.01 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $954.99 | Professional | None | $870.96 | $912.01 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,187.76 Typical High $3,388.44 | Facility | None | $707.95 | $2,187.76 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $912.01 | Professional | None | $630.96 | $630.96 | $912.01 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $3,388.44 | Facility | None | $1,023.29 | $1,819.70 | $3,388.44 |
United Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $912.01 | Professional | None | $562.34 | $660.69 | $912.01 |
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 $436.52 Median $457.09 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $181.97 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $691.83 Typical High $707.95 | Professional | 54 · Surgery only | $660.69 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $138.04 Typical High $141.25 | Professional | 55 · Aftercare only | $131.83 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $91.20 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $645.65 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $616.60 | $645.65 | $660.69 |
Where Delaware sits
The same service costs 8.3 times more in Wyoming 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· 42nd of 51
$832
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.