How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $194.98 Median $1,000.00 Typical High $2,041.74 | Facility | None | $194.98 | $1,000.00 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $263.03 | Professional | None | $194.98 | $213.80 | $263.03 |
BCBS Setting Facility Modifier None Typical Low $169.82 Median $380.19 Typical High $524.81 | Facility | None | $169.82 | $380.19 | $524.81 |
BCBS Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $323.59 | Professional | None | $169.82 | $223.87 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $158.49 Typical High $512.86 | Facility | None | $131.83 | $158.49 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $380.19 | Professional | None | $162.18 | $218.78 | $380.19 |
United Setting Facility Modifier None Typical Low $79.43 Median $131.83 Typical High $741.31 | Facility | None | $79.43 | $131.83 | $741.31 |
United Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $371.54 | Professional | None | $158.49 | $223.87 | $371.54 |
6 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 $97.72 Median $104.71 Typical High $131.83 | Professional | 52 · Reduced service | $97.72 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $42.66 Typical High $52.48 | Professional | 53 · Discontinued | $38.90 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $158.49 Typical High $199.53 | Professional | 54 · Surgery only | $144.54 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $31.62 Typical High $39.81 | Professional | 55 · Aftercare only | $28.84 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.89 Typical High $26.30 | Professional | 56 · Pre-op care only | $19.50 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $147.91 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $134.90 | $147.91 | $186.21 |
Where Arkansas sits
The same service costs 3.5 times more in Alaska 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.
Arkansas· 29th of 51
$240
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.