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 $1,621.81 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,621.81 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,621.81 | $1,621.81 |
BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $8,511.38 | Facility | None | $6,165.95 | $6,165.95 | $8,511.38 |
BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,412.54 | $1,548.82 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,818.38 Typical High $3,388.44 | Facility | None | $588.84 | $2,818.38 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $2,238.72 | Professional | None | $1,258.93 | $2,137.96 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $6,918.31 | Facility | None | $1,479.11 | $2,041.74 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,445.44 | $2,511.89 |
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 $602.56 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $602.56 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $239.88 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $912.01 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $181.97 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $120.23 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $851.14 | $1,148.15 | $1,148.15 |
Where Arkansas sits
The same service costs 15.1 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· 24th of 51
$1,862
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.