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 $42.66 Median $87.10 Typical High $7,244.36 | Facility | None | $42.66 | $87.10 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $144.54 | Professional | None | $50.12 | $87.10 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $74.13 Typical High $151.36 | Facility | None | $56.23 | $74.13 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $169.82 | Professional | None | $57.54 | $81.28 | $169.82 |
Highmark BCBS Setting Facility Modifier None Typical Low $112.20 Median $208.93 Typical High $218.78 | Facility | None | $112.20 | $208.93 | $218.78 |
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 $47.86 Median $81.28 Typical High $165.96 | Professional | None | $47.86 | $81.28 | $165.96 |
5 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 $25.12 Median $28.84 Typical High $43.65 | Professional | 52 · Reduced service | $25.12 | $28.84 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $11.48 Typical High $17.38 | Professional | 53 · Discontinued | $10.00 | $11.48 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $43.65 Typical High $64.57 | Professional | 54 · Surgery only | $37.15 | $43.65 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.71 Typical High $12.88 | Professional | 55 · Aftercare only | $7.41 | $8.71 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.75 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.01 | $5.75 | $8.71 |
Where Delaware sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 34th of 51
$87.10
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.