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 $5,370.32 | Facility | None | $1,071.52 | $1,862.09 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $5,370.32 Typical High $5,370.32 | Professional | None | $3,981.07 | $5,370.32 | $5,370.32 |
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 $3,162.28 Median $6,918.31 Typical High $7,943.28 | Professional | None | $3,162.28 | $6,918.31 | $7,943.28 |
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 $3,548.13 Median $4,265.80 Typical High $8,317.64 | Professional | None | $3,548.13 | $4,265.80 | $8,317.64 |
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 $1,995.26 Median $2,691.53 Typical High $2,691.53 | Professional | 52 · Reduced service | $1,995.26 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $1,071.52 Typical High $1,071.52 | Professional | 53 · Discontinued | $794.33 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,981.07 Typical High $3,981.07 | Professional | 54 · Surgery only | $3,019.95 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $794.33 Typical High $794.33 | Professional | 55 · Aftercare only | $602.56 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $398.11 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $3,715.35 Typical High $3,715.35 | Professional | 78 · Unplanned return to OR | $2,818.38 | $3,715.35 | $3,715.35 |
Where Arkansas sits
The same service costs 21.4 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· 25th of 51
$5,370
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.