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 $2,454.71 | Facility | None | $1,071.52 | $1,819.70 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,548.82 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,548.13 Typical High $4,265.80 | Facility | None | $588.84 | $3,548.13 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $2,884.03 | Professional | None | $1,698.24 | $2,570.40 | $2,884.03 |
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 $1,380.38 Median $1,819.70 Typical High $3,235.94 | Professional | None | $1,380.38 | $1,819.70 | $3,235.94 |
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 $776.25 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $776.25 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $309.03 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,148.15 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $229.09 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $154.88 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,479.11 | $1,479.11 |
Where Arkansas sits
The same service costs 18.2 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· 30th of 51
$2,138
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.