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 $2,454.71 | Facility | None | $1,071.52 | $1,862.09 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,778.28 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,000.00 | Facility | None | $501.19 | $501.19 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $2,630.27 Typical High $3,388.44 | Professional | None | $1,202.26 | $2,630.27 | $3,388.44 |
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 $1,479.11 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,479.11 | $1,995.26 | $3,311.31 |
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 $870.96 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $870.96 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $354.81 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,318.26 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $263.03 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,380.38 | $1,380.38 |
Where Arkansas sits
The same service costs 5.5 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
$1,514
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.