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 $1,698.24 Typical High $2,818.38 | Facility | None | $1,174.90 | $1,698.24 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,698.24 | $1,698.24 |
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 $1,318.26 Median $2,238.72 Typical High $2,344.23 | Professional | None | $1,318.26 | $2,238.72 | $2,344.23 |
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 $1,148.15 Median $1,513.56 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,513.56 | $2,630.27 |
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 $630.96 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $630.96 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $257.04 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $954.99 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $190.55 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $125.89 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $891.25 | $1,174.90 | $1,174.90 |
Where Arkansas sits
The same service costs 18.6 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· 24th of 51
$1,905
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.