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 $154.88 Median $398.11 Typical High $7,244.36 | Facility | None | $154.88 | $398.11 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $288.40 | Professional | None | $154.88 | $223.87 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $281.84 Typical High $588.84 | Facility | None | $190.55 | $281.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $218.78 | Professional | None | $128.82 | $194.98 | $218.78 |
Highmark BCBS Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $10,715.19 | Facility | None | $338.84 | $338.84 | $10,715.19 |
Highmark BCBS Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $1,230.27 | Professional | None | $154.88 | $239.88 | $1,230.27 |
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 $120.23 Median $173.78 Typical High $263.03 | Professional | None | $120.23 | $173.78 | $263.03 |
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 $77.62 Median $89.13 Typical High $125.89 | Professional | 52 · Reduced service | $77.62 | $89.13 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $35.48 Typical High $51.29 | Professional | 53 · Discontinued | $30.90 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $131.83 Typical High $190.55 | Professional | 54 · Surgery only | $114.82 | $131.83 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $26.30 Typical High $38.02 | Professional | 55 · Aftercare only | $22.91 | $26.30 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $17.78 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.49 | $17.78 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $123.03 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $107.15 | $123.03 | $177.83 |
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· 45th of 51
$200
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.