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 $831.76 Median $1,380.38 Typical High $2,454.71 | Facility | None | $831.76 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $831.76 | Professional | None | $645.65 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,467.37 Typical High $4,168.69 | Facility | None | $588.84 | $3,467.37 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,202.26 | Professional | None | $645.65 | $1,023.29 | $1,202.26 |
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 $588.84 Median $812.83 Typical High $1,318.26 | Professional | None | $588.84 | $812.83 | $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 $323.59 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $323.59 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $128.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $489.78 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $97.72 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $64.57 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $457.09 | $588.84 | $588.84 |
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· 25th of 51
$1,023
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.