How much rates vary
Facilitymedian $2,512 · 10th to 90th $977 to $9,550Professionalmedian $1,288 · 10th to 90th $955 to $1,820
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 $1,071.52 Median $1,513.56 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,513.56 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,288.25 | Professional | None | $977.24 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $8,128.31 Typical High $10,232.93 | Facility | None | $588.84 | $8,128.31 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,737.80 Typical High $1,819.70 | Professional | None | $977.24 | $1,737.80 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $2,511.89 Typical High $9,120.11 | Facility | None | $1,659.59 | $2,511.89 | $9,120.11 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,995.26 | Professional | None | $891.25 | $1,174.90 | $1,995.26 |
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 $489.78 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $489.78 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $194.98 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $741.31 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $147.91 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $97.72 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $691.83 | $891.25 | $891.25 |
Where Arkansas sits
The same service costs 6.0 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 $15,585KY $2,601
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.