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 $165.96 Median $302.00 Typical High $7,244.36 | Facility | None | $165.96 | $302.00 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $316.23 | Professional | None | $165.96 | $245.47 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $331.13 Typical High $588.84 | Facility | None | $223.87 | $331.13 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $263.03 | Professional | None | $134.90 | $239.88 | $263.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $7,585.78 | Facility | None | $1,445.44 | $2,818.38 | $7,585.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $549.54 | Professional | None | $162.18 | $281.84 | $549.54 |
United Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,398.83 | Facility | None | $416.87 | $616.60 | $2,398.83 |
United Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $316.23 | Professional | None | $128.82 | $208.93 | $316.23 |
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 $81.28 Median $93.33 Typical High $151.36 | Professional | 52 · Reduced service | $81.28 | $93.33 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $38.02 Typical High $60.26 | Professional | 53 · Discontinued | $33.11 | $38.02 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $141.25 Typical High $229.09 | Professional | 54 · Surgery only | $123.03 | $141.25 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.18 Typical High $45.71 | Professional | 55 · Aftercare only | $24.55 | $28.18 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.62 Typical High $30.20 | Professional | 56 · Pre-op care only | $16.60 | $18.62 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $131.83 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $114.82 | $131.83 | $213.80 |
Where Delaware sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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
$240
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.