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 $38.02 Median $58.88 Typical High $72.44 | Facility | None | $38.02 | $58.88 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $60.26 Typical High $81.28 | Professional | None | $38.02 | $60.26 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $125.89 Typical High $173.78 | Facility | None | $85.11 | $125.89 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $87.10 | Professional | None | $48.98 | $74.13 | $87.10 |
Highmark BCBS Setting Professional Modifier None Typical Low $63.10 Median $114.82 Typical High $218.78 | Professional | None | $63.10 | $114.82 | $218.78 |
United Setting Professional Modifier None Typical Low $38.90 Median $57.54 Typical High $77.62 | Professional | None | $38.90 | $57.54 | $77.62 |
4 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 $19.05 Median $27.54 Typical High $28.84 | Professional | 52 · Reduced service | $19.05 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $8.32 Typical High $8.71 | Professional | 55 · Aftercare only | $5.75 | $8.32 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.50 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.80 | $5.50 | $5.75 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $69.18 Median $102.33 Typical High $213.80 | Professional | 25 · Same-day visit | $69.18 | $102.33 | $213.80 |
Where Delaware sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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
$61.66
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.