How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,023 to $7,079Professionalmedian $1,349 · 10th to 90th $1,000 to $1,950
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 $1,023.29 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,023.29 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,570.88 Typical High $5,370.32 | Facility | None | $588.84 | $4,570.88 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,819.70 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,819.70 | $1,949.84 |
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 $933.25 Median $1,258.93 Typical High $2,089.30 | Professional | None | $933.25 | $1,258.93 | $2,089.30 |
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 $512.86 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $512.86 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $204.17 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $776.25 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $154.88 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $102.33 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $724.44 | $954.99 | $954.99 |
Where Arkansas sits
The same service costs 5.1 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 $14,343KY $2,808
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.