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 $67.61 Median $151.36 Typical High $7,244.36 | Facility | None | $67.61 | $151.36 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $158.49 | Professional | None | $67.61 | $85.11 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $234.42 | Professional | None | $67.61 | $131.83 | $234.42 |
United Setting Professional Modifier None Typical Low $53.70 Median $125.89 Typical High $234.42 | Professional | None | $53.70 | $125.89 | $234.42 |
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 $33.11 Median $40.74 Typical High $77.62 | Professional | 52 · Reduced service | $33.11 | $40.74 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $16.22 Typical High $30.90 | Professional | 53 · Discontinued | $13.49 | $16.22 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $60.26 Typical High $114.82 | Professional | 54 · Surgery only | $50.12 | $60.26 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.02 Typical High $22.91 | Professional | 55 · Aftercare only | $10.00 | $12.02 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.13 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.76 | $8.13 | $15.49 |
Where Delaware sits
The same service costs 3.5 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· 39th of 51
$129
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.