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 $2,454.71 | Facility | None | $1,071.52 | $1,862.09 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,862.09 | $2,089.30 | $2,089.30 |
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 $1,230.27 Median $2,884.03 Typical High $3,548.13 | Professional | None | $1,230.27 | $2,884.03 | $3,548.13 |
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 $1,584.89 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,584.89 | $2,089.30 | $3,630.78 |
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 $933.25 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $933.25 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $371.54 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,380.38 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $281.84 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,479.11 | $1,479.11 |
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· 48th of 51
$1,622
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.