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 $4.79 Median $6.31 Typical High $125.89 | Facility | None | $4.79 | $6.31 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $97.72 Typical High $131.83 | Professional | None | $5.01 | $97.72 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $131.83 | Professional | None | $85.11 | $109.65 | $131.83 |
Highmark BCBS Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
United Setting Professional Modifier None Typical Low $75.86 Median $102.33 Typical High $138.04 | Professional | None | $75.86 | $102.33 | $138.04 |
3 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 $3.09 Median $3.24 Typical High $54.95 | Professional | 52 · Reduced service | $3.09 | $3.24 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.80 Typical High $17.78 | Professional | 55 · Aftercare only | $10.72 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $9.33 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.08 | $9.33 | $12.02 |
Where Delaware sits
The same service costs 2.5 times more in Alaska than in Alabama. 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· 38th of 51
$100
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.