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 $208.93 Median $331.13 Typical High $7,244.36 | Facility | None | $208.93 | $331.13 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $331.13 | Professional | None | $208.93 | $239.88 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $389.05 Typical High $2,137.96 | Facility | None | $263.03 | $389.05 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $316.23 | Professional | None | $169.82 | $251.19 | $316.23 |
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 $186.21 Median $251.19 Typical High $371.54 | Professional | None | $186.21 | $251.19 | $371.54 |
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 $104.71 Median $120.23 Typical High $165.96 | Professional | 52 · Reduced service | $104.71 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $66.07 | Professional | 53 · Discontinued | $41.69 | $47.86 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $177.83 Typical High $251.19 | Professional | 54 · Surgery only | $154.88 | $177.83 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $36.31 Typical High $50.12 | Professional | 55 · Aftercare only | $30.90 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.99 Typical High $33.11 | Professional | 56 · Pre-op care only | $20.89 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $165.96 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $144.54 | $165.96 | $234.42 |
Where Delaware sits
The same service costs 4.2 times more in Wyoming 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· 46th of 51
$263
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.