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 $1,071.52 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,445.44 | $1,445.44 |
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 $1,122.02 Median $1,949.84 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,949.84 | $2,041.74 |
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 $1,000.00 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,000.00 | $1,380.38 | $2,238.72 |
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 $537.03 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $537.03 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $213.80 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $812.83 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $162.18 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $107.15 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $758.58 | $1,000.00 | $1,000.00 |
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· 24th of 51
$1,660
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.