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 $4,073.80 Median $5,370.32 Typical High $5,370.32 | Professional | None | $4,073.80 | $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 $3,235.94 Median $7,079.46 Typical High $7,943.28 | Professional | None | $3,235.94 | $7,079.46 | $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 $3,630.78 Median $4,265.80 Typical High $8,511.38 | Professional | None | $3,630.78 | $4,265.80 | $8,511.38 |
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 $2,041.74 Median $2,691.53 Typical High $2,691.53 | Professional | 52 · Reduced service | $2,041.74 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $1,071.52 Typical High $1,071.52 | Professional | 53 · Discontinued | $812.83 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $4,073.80 Typical High $4,073.80 | Professional | 54 · Surgery only | $3,019.95 | $4,073.80 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $812.83 Typical High $812.83 | Professional | 55 · Aftercare only | $616.60 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $537.03 Typical High $537.03 | Professional | 56 · Pre-op care only | $407.38 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $3,801.89 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $2,818.38 | $3,801.89 | $3,801.89 |
Where Arkansas sits
The same service costs 21.9 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· 27th 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.