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 $870.96 Median $1,698.24 Typical High $2,818.38 | Facility | None | $870.96 | $1,698.24 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $870.96 | Professional | None | $691.83 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,388.44 Typical High $3,981.07 | Facility | None | $588.84 | $3,388.44 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,202.26 Typical High $1,380.38 | Professional | None | $676.08 | $1,202.26 | $1,380.38 |
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 $602.56 Median $851.14 Typical High $1,318.26 | Professional | None | $602.56 | $851.14 | $1,318.26 |
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 $346.74 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $346.74 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $524.81 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $489.78 | $602.56 | $602.56 |
Where Arkansas sits
The same service costs 7.2 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· 18th of 51
$1,175
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.