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 $1,995.26 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,995.26 | $2,344.23 | $2,344.23 |
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 $1,380.38 Median $3,235.94 Typical High $4,073.80 | Professional | None | $1,380.38 | $3,235.94 | $4,073.80 |
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 $1,819.70 Median $2,570.40 Typical High $3,981.07 | Professional | None | $1,819.70 | $2,570.40 | $3,981.07 |
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 $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,047.13 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $416.87 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,584.89 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $316.23 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,659.59 | $1,659.59 |
Where Arkansas sits
The same service costs 5.8 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
$1,738
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.