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 $1,071.52 Median $1,819.70 Typical High $3,162.28 | Facility | None | $1,071.52 | $1,819.70 | $3,162.28 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,398.83 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,365.16 Typical High $5,248.07 | Facility | None | $588.84 | $4,365.16 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $4,265.80 Typical High $4,365.16 | Professional | None | $2,454.71 | $4,265.80 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $9,120.11 | Facility | None | $1,698.24 | $2,570.40 | $9,120.11 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $4,897.79 | Professional | None | $2,187.76 | $2,951.21 | $4,897.79 |
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 $1,202.26 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,202.26 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $478.63 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,819.70 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $363.08 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $239.88 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,238.72 | $2,238.72 |
Where Arkansas sits
The same service costs 8.7 times more in Alaska than in Texas. 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· 33rd of 51
$3,162
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.