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 $323.59 Median $512.86 Typical High $7,244.36 | Facility | None | $323.59 | $512.86 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $512.86 | Professional | None | $323.59 | $371.54 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,479.11 Typical High $2,137.96 | Facility | None | $645.65 | $1,479.11 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $446.68 | Professional | None | $234.42 | $338.84 | $446.68 |
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 $223.87 Median $309.03 Typical High $512.86 | Professional | None | $223.87 | $309.03 | $512.86 |
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 $162.18 Median $186.21 Typical High $257.04 | Professional | 52 · Reduced service | $162.18 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $74.13 Typical High $102.33 | Professional | 53 · Discontinued | $64.57 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $281.84 Typical High $389.05 | Professional | 54 · Surgery only | $245.47 | $281.84 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $56.23 Typical High $77.62 | Professional | 55 · Aftercare only | $48.98 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $37.15 Typical High $51.29 | Professional | 56 · Pre-op care only | $32.36 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $263.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $229.09 | $263.03 | $363.08 |
Where Delaware sits
The same service costs 5.9 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· 49th of 51
$339
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.