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 $2,884.03 | Facility | None | $1,071.52 | $1,862.09 | $2,884.03 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,398.83 | $2,884.03 | $2,884.03 |
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 $1,698.24 Median $3,890.45 Typical High $4,897.79 | Professional | None | $1,698.24 | $3,890.45 | $4,897.79 |
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 $2,238.72 Median $3,090.30 Typical High $5,011.87 | Professional | None | $2,238.72 | $3,090.30 | $5,011.87 |
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 $1,258.93 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,258.93 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $512.86 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,905.46 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $380.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,995.26 | $1,995.26 |
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· 50th 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.