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 $1,122.02 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $4,466.84 Typical High $5,370.32 | Facility | None | $588.84 | $4,466.84 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,949.84 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,949.84 | $1,995.26 |
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 $1,023.29 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,318.26 | $2,290.87 |
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 $549.54 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $549.54 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $223.87 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $831.76 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $165.96 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $112.20 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $776.25 | $1,023.29 | $1,023.29 |
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.