How much rates vary
Facilitymedian $1,950 · 10th to 90th $1,047 to $6,918Professionalmedian $1,047 · 10th to 90th $759 to $1,514
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 $1,047.13 Median $1,380.38 Typical High $2,454.71 | Facility | None | $1,047.13 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,047.13 | Professional | None | $794.33 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,513.56 Typical High $1,862.09 | Facility | None | $588.84 | $1,513.56 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,445.44 Typical High $1,513.56 | Professional | None | $812.83 | $1,445.44 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $7,413.10 | Facility | None | $1,698.24 | $2,570.40 | $7,413.10 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,584.89 | Professional | None | $724.44 | $1,000.00 | $1,584.89 |
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 $398.11 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $398.11 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $158.49 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $588.84 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $117.49 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $79.43 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $549.54 | $724.44 | $724.44 |
Where Arkansas sits
The same service costs 5.0 times more in Alabama 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
AL $11,256KY $2,261
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.