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 $6,025.60 Typical High $7,244.36 | Facility | None | $912.01 | $6,025.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $933.25 | Professional | None | $912.01 | $912.01 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $2,754.23 Typical High $4,365.16 | Facility | None | $870.96 | $2,754.23 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $1,000.00 | Professional | None | $724.44 | $758.58 | $1,000.00 |
United Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,570.40 | Facility | None | $912.01 | $1,258.93 | $2,570.40 |
United Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,000.00 | Professional | None | $630.96 | $724.44 | $1,000.00 |
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 $457.09 Median $457.09 Typical High $467.74 | Professional | 52 · Reduced service | $457.09 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $190.55 | Professional | 53 · Discontinued | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $707.95 | Professional | 54 · Surgery only | $676.08 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $141.25 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $660.69 |
Where Delaware sits
The same service costs 7.6 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· 44th of 51
$871
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.