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 $4,073.80 | Facility | None | $1,071.52 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,388.44 | $4,073.80 | $4,073.80 |
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 $2,398.83 Median $5,495.41 Typical High $7,079.46 | Professional | None | $2,398.83 | $5,495.41 | $7,079.46 |
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 $3,090.30 Median $4,365.16 Typical High $6,918.31 | Professional | None | $3,090.30 | $4,365.16 | $6,918.31 |
5 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 $1,819.70 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,819.70 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $724.44 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,754.23 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $363.08 | $407.38 | $407.38 |
Where Arkansas sits
The same service costs 7.4 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
$1,820
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.