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 $33.88 Median $53.70 Typical High $7,244.36 | Facility | None | $33.88 | $53.70 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $43.65 Typical High $58.88 | Professional | None | $30.90 | $43.65 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $707.95 Typical High $2,290.87 | Facility | None | $45.71 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
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 $30.20 Median $44.67 Typical High $77.62 | Professional | None | $30.20 | $44.67 | $77.62 |
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 $16.98 Median $18.62 Typical High $26.92 | Professional | 52 · Reduced service | $16.98 | $18.62 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.41 Typical High $10.72 | Professional | 53 · Discontinued | $6.76 | $7.41 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $28.18 Typical High $40.74 | Professional | 54 · Surgery only | $25.70 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.62 Typical High $8.13 | Professional | 55 · Aftercare only | $5.13 | $5.62 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.72 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.39 | $3.72 | $5.37 |
Where Delaware sits
The same service costs 2.8 times more in Alaska than in California. 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
$46.77
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.