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 $1,445.44 Median $6,606.93 Typical High $7,244.36 | Facility | None | $1,445.44 | $6,606.93 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,380.38 | $1,445.44 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,754.23 Typical High $4,265.80 | Facility | None | $1,000.00 | $2,754.23 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,412.54 | Professional | None | $1,047.13 | $1,047.13 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $3,388.44 | Facility | None | $1,023.29 | $1,819.70 | $3,388.44 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,445.44 | Professional | None | $912.01 | $1,071.52 | $1,445.44 |
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 $691.83 Median $724.44 Typical High $741.31 | Professional | 52 · Reduced service | $691.83 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $288.40 Typical High $295.12 | Professional | 53 · Discontinued | $275.42 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,071.52 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,047.13 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $213.80 Typical High $223.87 | Professional | 55 · Aftercare only | $208.93 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $144.54 Typical High $147.91 | Professional | 56 · Pre-op care only | $138.04 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,000.00 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $977.24 | $1,000.00 | $1,047.13 |
Where Delaware sits
The same service costs 7.1 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· 45th of 51
$1,202
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.