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 $1,148.15 Median $4,897.79 Typical High $7,244.36 | Facility | None | $1,148.15 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,174.90 | Professional | None | $1,122.02 | $1,148.15 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,698.24 Typical High $2,454.71 | Facility | None | $707.95 | $1,698.24 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $912.01 Typical High $1,202.26 | Professional | None | $891.25 | $912.01 | $1,202.26 |
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 $776.25 Median $891.25 Typical High $1,230.27 | Professional | None | $776.25 | $891.25 | $1,230.27 |
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 $562.34 Median $575.44 Typical High $588.84 | Professional | 52 · Reduced service | $562.34 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $234.42 | Professional | 53 · Discontinued | $223.87 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | 54 · Surgery only | $851.14 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $117.49 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $831.76 |
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· 43rd of 51
$1,096
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.