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 $2,511.89 | Facility | None | $1,071.52 | $1,862.09 | $2,511.89 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,089.30 | $2,511.89 | $2,511.89 |
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 $1,445.44 Median $3,388.44 Typical High $4,265.80 | Professional | None | $1,445.44 | $3,388.44 | $4,265.80 |
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 $1,862.09 Median $2,238.72 Typical High $4,265.80 | Professional | None | $1,862.09 | $2,238.72 | $4,265.80 |
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 $1,096.48 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,096.48 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $446.68 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,659.59 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $331.13 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $218.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,737.80 | $1,737.80 |
Where Arkansas sits
The same service costs 5.4 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· 50th of 51
$1,738
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.