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 $3,890.45 | Facility | None | $1,071.52 | $1,862.09 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $3,235.94 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,235.94 | $3,890.45 | $3,890.45 |
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 $2,290.87 Median $5,248.07 Typical High $6,760.83 | Professional | None | $2,290.87 | $5,248.07 | $6,760.83 |
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 $2,951.21 Median $3,630.78 Typical High $6,760.83 | Professional | None | $2,951.21 | $3,630.78 | $6,760.83 |
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 $1,737.80 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $1,737.80 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $691.83 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,570.40 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $512.86 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $346.74 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,754.23 | $2,754.23 |
Where Arkansas sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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· 51st of 51
$1,995
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.