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 $123.03 Median $141.25 Typical High $7,244.36 | Facility | None | $123.03 | $141.25 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $125.89 Typical High $144.54 | Professional | None | $123.03 | $125.89 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $120.23 Typical High $177.83 | Facility | None | $58.88 | $120.23 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $144.54 | Professional | None | $93.33 | $107.15 | $144.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Highmark BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $1,698.24 | Facility | None | $83.18 | $114.82 | $1,698.24 |
United Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $141.25 | Professional | None | $87.10 | $102.33 | $141.25 |
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 $61.66 Median $63.10 Typical High $70.79 | Professional | 52 · Reduced service | $61.66 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.12 Typical High $28.18 | Professional | 53 · Discontinued | $24.55 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $93.33 Typical High $104.71 | Professional | 54 · Surgery only | $91.20 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $21.38 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.59 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.30 | $12.59 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $87.10 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $85.11 | $87.10 | $97.72 |
Where Delaware sits
The same service costs 4.4 times more in Alaska than in Florida. 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
$115
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.