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 $676.08 Median $6,025.60 Typical High $7,244.36 | Facility | None | $676.08 | $6,025.60 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | None | $676.08 | $676.08 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $2,187.76 Typical High $3,388.44 | Facility | None | $870.96 | $2,187.76 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $741.31 | Professional | None | $537.03 | $562.34 | $741.31 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $3,388.44 | Facility | None | $1,023.29 | $1,819.70 | $3,388.44 |
United Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $741.31 | Professional | None | $501.19 | $562.34 | $741.31 |
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 $338.84 Median $338.84 Typical High $346.74 | Professional | 52 · Reduced service | $338.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $138.04 | Professional | 53 · Discontinued | $134.90 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $512.86 | Professional | 54 · Surgery only | $501.19 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $69.18 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $478.63 |
Where Delaware sits
The same service costs 8.5 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· 40th of 51
$676
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.