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 $3,235.94 | Facility | None | $1,071.52 | $1,862.09 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,454.71 | $3,235.94 | $3,235.94 |
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 $2,454.71 Median $4,265.80 Typical High $4,897.79 | Professional | None | $2,454.71 | $4,265.80 | $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 $2,454.71 Median $2,754.23 Typical High $5,128.61 | Professional | None | $2,454.71 | $2,754.23 | $5,128.61 |
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 $1,288.25 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,288.25 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $512.86 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,949.84 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $389.05 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $257.04 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,290.87 | $2,290.87 |
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· 30th of 51
$3,236
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.