How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,047 to $5,623Professionalmedian $1,995 · 10th to 90th $1,479 to $2,754
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 $1,995.26 Typical High $2,818.38 | Facility | None | $1,174.90 | $1,995.26 | $2,818.38 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,513.56 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,570.88 Typical High $5,495.41 | Facility | None | $588.84 | $4,570.88 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,630.27 Typical High $2,754.23 | Professional | None | $1,548.82 | $2,630.27 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,412.54 | $1,995.26 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $3,090.30 | Professional | None | $1,380.38 | $1,819.70 | $3,090.30 |
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 $741.31 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $741.31 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $302.00 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,122.02 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $223.87 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $151.36 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,412.54 | $1,412.54 |
Where Arkansas sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $16,761KY $3,604
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.