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 $1,071.52 Median $1,862.09 Typical High $4,570.88 | Facility | None | $1,071.52 | $1,862.09 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $4,570.88 Typical High $4,570.88 | Professional | None | $3,019.95 | $4,570.88 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,023.29 | Facility | None | $501.19 | $501.19 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $5,754.40 Typical High $7,244.36 | Professional | None | $2,511.89 | $5,754.40 | $7,244.36 |
United Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $1,995.26 | Facility | None | $281.84 | $457.09 | $1,995.26 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $3,388.44 Typical High $6,606.93 | Professional | None | $2,089.30 | $3,388.44 | $6,606.93 |
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 $1,584.89 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,584.89 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $912.01 Typical High $912.01 | Professional | 53 · Discontinued | $630.96 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $3,388.44 Typical High $3,388.44 | Professional | 54 · Surgery only | $2,344.23 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $691.83 Typical High $691.83 | Professional | 55 · Aftercare only | $467.74 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $316.23 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $3,162.28 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $2,187.76 | $3,162.28 | $3,162.28 |
Where Arkansas sits
The same service costs 10.7 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· 49th of 51
$2,570
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.