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 $223.87 Median $257.04 Typical High $7,244.36 | Facility | None | $223.87 | $257.04 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $309.03 | Professional | None | $223.87 | $257.04 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $234.42 Typical High $588.84 | Facility | None | $147.91 | $234.42 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $245.47 | Professional | None | $181.97 | $204.17 | $245.47 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $5,495.41 | Facility | None | $3,467.37 | $3,467.37 | $5,495.41 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $3,311.31 | Professional | None | $1,778.28 | $1,778.28 | $3,311.31 |
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 $173.78 Median $204.17 Typical High $281.84 | Professional | None | $173.78 | $204.17 | $281.84 |
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 $112.20 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $112.20 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $47.86 Typical High $51.29 | Professional | 53 · Discontinued | $44.67 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $169.82 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $33.88 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.99 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.39 | $23.99 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $165.96 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $158.49 | $165.96 | $181.97 |
Where Delaware sits
The same service costs 4.3 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
$214
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.