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 $245.47 Median $398.11 Typical High $7,244.36 | Facility | None | $245.47 | $398.11 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $398.11 | Professional | None | $245.47 | $281.84 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $398.11 Typical High $1,819.70 | Facility | None | $269.15 | $398.11 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $354.81 | Professional | None | $208.93 | $316.23 | $354.81 |
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 $199.53 Median $281.84 Typical High $407.38 | Professional | None | $199.53 | $281.84 | $407.38 |
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 $123.03 Median $141.25 Typical High $199.53 | Professional | 52 · Reduced service | $123.03 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $56.23 Typical High $79.43 | Professional | 53 · Discontinued | $48.98 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $208.93 Typical High $295.12 | Professional | 54 · Surgery only | $186.21 | $208.93 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $41.69 Typical High $58.88 | Professional | 55 · Aftercare only | $37.15 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.18 Typical High $39.81 | Professional | 56 · Pre-op care only | $24.55 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $194.98 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $173.78 | $194.98 | $275.42 |
Where Delaware sits
The same service costs 3.9 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· 44th of 51
$316
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.