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 $524.81 Median $537.03 Typical High $7,244.36 | Facility | None | $524.81 | $537.03 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $588.84 | Professional | None | $524.81 | $537.03 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $467.74 Typical High $741.31 | Facility | None | $323.59 | $467.74 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $588.84 | Professional | None | $426.58 | $512.86 | $588.84 |
United Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,698.24 | Facility | None | $229.09 | $398.11 | $1,698.24 |
United Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $676.08 | Professional | None | $436.52 | $549.54 | $676.08 |
7 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 $257.04 Median $269.15 Typical High $275.42 | Professional | 52 · Reduced service | $257.04 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $107.15 Typical High $112.20 | Professional | 53 · Discontinued | $104.71 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $398.11 Typical High $416.87 | Professional | 54 · Surgery only | $389.05 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $77.62 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $53.70 Typical High $54.95 | Professional | 56 · Pre-op care only | $52.48 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $371.54 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $363.08 | $371.54 | $389.05 |
Highmark BCBS Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 79 · Unrelated procedure after surgery | $524.81 | $524.81 | $524.81 |
Where Delaware sits
The same service costs 6.2 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
$537
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.