How much rates vary
Facilitymedian $513 · 10th to 90th $309 to $1,995Professionalmedian $1,349 · 10th to 90th $1,047 to $2,089
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 $1,380.38 Typical High $2,454.71 | Facility | None | $1,071.52 | $1,380.38 | $2,454.71 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,258.93 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,000.00 | Facility | None | $501.19 | $501.19 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,621.81 Typical High $2,089.30 | Professional | None | $891.25 | $1,621.81 | $2,089.30 |
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 $1,000.00 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,380.38 | $2,290.87 |
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 $616.60 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $616.60 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $251.19 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $933.25 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $186.21 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $125.89 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $870.96 | $933.25 | $933.25 |
Where Arkansas sits
The same service costs 9.9 times more in Alabama than in Maryland. 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.
Physician feeFacility fee
AL $18,241MD $1,851
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.