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 $1,174.90 Median $1,862.09 Typical High $2,818.38 | Facility | None | $1,174.90 | $1,862.09 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,621.81 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,388.44 Typical High $4,168.69 | Facility | None | $588.84 | $3,388.44 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $2,754.23 | Professional | None | $1,513.56 | $2,511.89 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $2,511.89 Typical High $9,120.11 | Facility | None | $1,659.59 | $2,511.89 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $3,162.28 | Professional | None | $1,348.96 | $1,737.80 | $3,162.28 |
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 $794.33 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $794.33 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $323.59 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,202.26 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $239.88 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $162.18 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,445.44 | $1,445.44 |
Where Arkansas sits
The same service costs 11.2 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· 31st of 51
$2,042
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.