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 $104.71 Median $120.23 Typical High $7,244.36 | Facility | None | $104.71 | $120.23 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $123.03 | Professional | None | $104.71 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $54.95 Typical High $60.26 | Professional | 52 · Reduced service | $52.48 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.39 Typical High $23.99 | Professional | 53 · Discontinued | $20.89 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $83.18 Typical High $91.20 | Professional | 54 · Surgery only | $79.43 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.96 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.47 | $10.96 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $85.11 Typical High $151.36 | Facility | None | $56.23 | $85.11 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $128.82 | Professional | None | $89.13 | $97.72 | $128.82 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $131.83 | Professional | None | $85.11 | $97.72 | $131.83 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 79 · Unrelated procedure after surgery | $120.23 | $120.23 | $120.23 |
Where Delaware sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 50th of 51
$100
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.