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 $323.59 Median $363.08 Typical High $426.58 | Facility | None | $323.59 | $363.08 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $426.58 | Professional | None | $257.04 | $363.08 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Highmark BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
United Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $467.74 | Professional | None | $239.88 | $331.13 | $467.74 |
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 $154.88 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $154.88 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $87.10 Typical High $89.13 | Professional | 53 · Discontinued | $61.66 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $46.77 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $30.90 | $42.66 | $44.67 |
Where Delaware sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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
$363
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.