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 $1,778.28 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,778.28 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,584.89 | $1,778.28 | $1,778.28 |
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 $1,071.52 Median $2,398.83 Typical High $3,019.95 | Professional | None | $1,071.52 | $2,398.83 | $3,019.95 |
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 $1,318.26 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,318.26 | $1,949.84 | $3,019.95 |
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 $794.33 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $794.33 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $316.23 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,202.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $239.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $158.49 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,230.27 | $1,230.27 |
Where Arkansas sits
The same service costs 5.9 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· 47th of 51
$1,445
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.