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 $851.14 Median $2,238.72 Typical High $7,244.36 | Facility | None | $851.14 | $2,238.72 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $954.99 | Professional | None | $831.76 | $870.96 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $812.83 Typical High $2,137.96 | Facility | None | $588.84 | $812.83 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $870.96 | Professional | None | $602.56 | $660.69 | $870.96 |
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 $575.44 Median $724.44 Typical High $1,023.29 | Professional | None | $575.44 | $724.44 | $1,023.29 |
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 $426.58 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $426.58 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $630.96 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $144.54 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $676.08 |
Where Delaware sits
The same service costs 5.4 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· 48th of 51
$776
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.