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 $2,041.74 Typical High $2,818.38 | Facility | None | $1,174.90 | $2,041.74 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,548.82 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,365.16 Typical High $5,248.07 | Facility | None | $588.84 | $4,365.16 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $2,818.38 | Professional | None | $1,584.89 | $2,754.23 | $2,818.38 |
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 $1,412.54 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,905.46 | $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 $776.25 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $776.25 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $309.03 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,148.15 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $234.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $154.88 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,445.44 | $1,445.44 |
Where Arkansas sits
The same service costs 9.3 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· 29th of 51
$2,188
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.